Sandro Sironi MD, Presenter: Nothing to Disclose

Cristina Messa MD, Abstract Co-Author: Nothing to Disclose

Barbara Zangheri, Abstract Co-Author: Nothing to Disclose

Giorgia Mangili, Abstract Co-Author: Nothing to Disclose

Alessandro Del Maschio MD, Abstract Co-Author: Nothing to Disclose

Ferruccio Fazio, Abstract Co-Author: Nothing to Disclose

To prospectively evaluate the usefulness of integrated PET/CT for depicting persistent ovarian carcinoma after first-line treatment.

31 women (mean age, 55.9) had primary cytoreductive surgery followed by platinum regimen chemotherapy for histologically proven ovarian carcinoma. Tumor types were papillary serous adenocarcinoma (n=26), endometroid carcinoma (n=3), and mixed mullerian tumor (n=2). All patients underwent PET/CT examinations within 30 days of the completion of chemotherapy. PET studies were performed with a full-ring-detector clinical PET scanner (CTI PET HRT, Knoxville, TN) by injecting FDG (18F-fluoro-deoxy-glucose) intravenously and imaging after one hour. CT was performed prior to PET with 5 mm thick sections, without i.v. contrast material administration, using a multidetector row helical CT scanner (Somatom-Emotion, Siemens Medical System, Erlangen, Germany). Within 9 days of imaging studies, second-look procedure (SLP) (laparoscopy [n=7], or laparotomy [n=24]) was performed for histological confirmation. Imaging findings were then correlated with histopathologic findings in all cases.

17 (55%) of 31 patients had persistent tumor at histologic examination after SLP, and 14 (45%) of 31 had no histologically proven tumor. The total number of lesions found positive for tumor cells at histology was 41 (lymph nodes n=16; peritoneal lesions n=21; pelvic lesions n=4); maximum diameter of these lesions ranged from 0.3 to 3.2 cm (mean, 1.7 cm). The overall lesion-based sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT for revealing the presence of persistent tumor were as follows:78% (32/41), 75% (12/16), 77% (44/57), 89% (32/36) and 57% (12/21), respectively. A size threshold could be set at 0.5 cm, as this was the largest diameter of a lesion missed at PET/CT imaging.

Integrated PET/CT may be an effective means of evaluating persistent ovarian cancer, mainly because of its high PPV.

Sironi, S, Messa, C, Zangheri, B, Mangili, G, Del Maschio, A, Fazio, F, Value of Integrated FDG PET/CT for Assessment of Persistent Ovarian Cancer.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405943.html