Maria G. Skilakaki MD, Presenter: Nothing to Disclose

Evangelia Skoura, Abstract Co-Author: Nothing to Disclose

James Exarhos MD, Abstract Co-Author: Nothing to Disclose

Phivi Rondogianni MD, Abstract Co-Author: Nothing to Disclose

Chariklia Giannopoulou MD, Abstract Co-Author: Nothing to Disclose

Ioannis Datseris MD, Abstract Co-Author: Nothing to Disclose

Purpose: To assess the value of [18F] FDG-PET/CT in early diagnosis of recurrence in patients with previously treated intraabdominal malignancies who have rising tumor serum markers and negative conventional imaging evaluation.

Methods and Materials: From July 2007 to Dec. 2008, 36 patients,(16 men, 20 women), 39 -78 years old, with known intraabdominal malignancy ( 16 with colorectal cancer, 12 with ovarian cancer, 3 with cervical cancer, 2 with cancer of the stomach, 1 with cancer of the bladder, 1 with renal and 1 with anal cancer), status post-treatment, underwent [18F] FDG-PET/CT at our Institution for suspected recurrence because of progressively increased serum tumor markers (CEA, CA-125, CA 19-9, CA 15-3). All patients had recently performed (within less than 45 days) negative conventional imaging evaluation of the chest, upper and lower abdomen. Accuracy of PET/CT was compared to follow-up.

Results: Recurrence was found in 34 of 36 patients (94.4%): Of 16 patients with colorectal cancer, 5 had peritoneal metastases, 3 had lymphadenopathy, 3 had local recurrence in association with: peritoneal infiltration (1), lymphadenopathy (1) and pulmonary metastases (1), 2 had hepatic disease in association with: lymphadenopathy (1) and lung lesions (1), 1 had peritoneal implants and lymphadenopathy and 2 patients were negative. Of 12 women with ovarian cancer, 4 had peritoneal infiltration, 4 had lymphadenopathy, 3 had peritoneal disease in association with: lymphadenopathy (2) and hepatic lesions (1) and 1 had local recurrence and bone lesions. Of 3 women with cervical cancer 1 had peritoneal implants, 1 had lymphadenopathy and 1 had local recurrence and lymphadenopathy . Of 2 patients with cancer of the stomach, 1 had peritoneal disease and 1 had local recurrence and pulmonary metastases. Finally, the patient with cancer of the bladder had lymphadenopathy and the patients with anal and renal cancer had peritoneal implants in association with local recurrence and lymphadenopathy respectively.

Conclusion: [18F] FDG-PET/CT seems to be a very important tool in the evaluation of radiologically occult recurrent disease suggested by rising tumor markers in asymptomatic patients with previously treated intraabdominal cancer.

Clinical Relevance: [18F] FDG-PET/CT has the potential to increase the detectability rate for diagnosis of recurrent intraabdominal malignancies.

Skilakaki, M, Skoura, E, Exarhos, J, Rondogianni, P, Giannopoulou, C, Datseris, I, [18F]FDG-PET/CT Diagnosis of Recurrent Intraabdominal Cancer in Asymptomatic Patients with Elevated Tumor Marker Serum Levels and Negative Findings on Conventional Imaging Tests.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8004233.html