Role of 18F-FDG PET/CT in the Detection of Ovarian Cancer Recurrence in the Setting of Elevated Tumor Markers

Objectives: To evaluate the diagnostic
performance of 18F-flurodeoxyglucose
positron emission tomography/ computed
tomography in patients with suspected
biochemical ovarian tumor recurrence in
comparison to contrast enhanced CT.
Patients and Methods: A total of 64 18FFDG
PET/CT studies for patients with
biochemical suspicious ovarian tumor
recurrence were evaluated. Each patient
underwent 18F-FDG PET/CT and Ce-CT
scans in the same day. Studies were read
independently by one experienced
nuclear medicine physician and one
experienced radiologist. A four-point
score (score 0 = definitely benign, score
1 = probably benign, score 2 = probably
malignant and score 3 = definitely
malignant) used to assess the presence or
absence of recurrence (local, regional or
distant).
The final diagnosis of tumor status was
made on the basis of subsequent followup
by 18F-FDG PET/CT, conventional
imaging (CT/MRI) or histopathology
whenever possible. Results: Of the 64
studies evaluated, 61 (95%) studies had
tumor recurrence and 3 (5%) studies were
free based on final diagnosis. 18F-FDG
PET/CT & Ce-CT had sensitivity 97% vs.
87%, specificity 100% vs. 33%, and
accuracy of ( 97% vs. 84% ) respectively.
18F-FDG PET/CT was significantly more
sensitive and more accurate compared to
Ce-CT with P-value of 0.07 and 0.02;
respectively with no statistical significant
difference in accuracy.Conclusions: 18FFDG
PET/CT is more accurate than Ce-
CT in the diagnosis of ovarian tumor
recurrence in patients with elevated
tumor marker.