TY - JOUR
T1 - Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer
T2 - Correlation with transvaginal ultrasonography, computed tomography, and histology
AU - Castellucci, Paolo
AU - Perrone, Anna M.
AU - Picchio, Maria
AU - Ghi, Tullio
AU - Farsad, Mohsen
AU - Nanni, Cristina
AU - Messa, Cristina
AU - Meriggiola, Maria C.
AU - Pelusi, Giuseppe
AU - Al-Nahhas, Adil
AU - Rubello, Domenico
AU - Fazio, Ferruccio
AU - Fanti, Stefano
PY - 2007/8
Y1 - 2007/8
N2 - AIMS: To (a) assess the accuracy of F-FDG PET/CT in distinguishing malignant from benign pelvic lesions, compared to transvaginal ultrasonography (TVUS) and (b) to establish the role of whole-body F-FDG PET/CT, compared to contrast enhanced computed tomography (CT), in staging patients with ovarian cancer. PATIENTS: Fifty consecutive patients with a pelvic lesion, already scheduled for surgery on the basis of physical examination, TVUS, and serum Ca125 levels, were enrolled in the study. Patients' age ranged between 23 and 89 years (mean 64). All patients underwent TVUS including a colour Doppler study followed by a thorax and abdominal CT scan, and whole-body F-FDG PET/CT within 2 weeks prior to surgery. Histological findings obtained at surgery were taken as the 'gold standard' to compare F-FDG PET/CT and TVUS, and F-FDG PET/CT vs. CT. When tissue analysis showed ovarian cancer, the accuracy of F-FDG PET/CT and CT were compared for the purpose of obtaining a precise staging. RESULTS: At surgery, the ovarian lesions were malignant in 32/50 patients (64%) and benign in the remaining 18/50 patients (36%). The sensitivity, specificity, NPV, PPV and accuracy of F-FDG PET/CT were 87%, 100%, 81%, 100% and 92%, respectively, compared with 90%, 61%, 78%, 80% and 80%, respectively, for TVUS. In staging ovarian cancer, F-FDG PET/CT results were concordant with final pathological staging in 22/32 (69%) patients while CT results were concordant in 17/32 (53%) patients. CT incorrectly down-staged four out of six stage IV patients by missing distant metastasis in the liver, pleura, mediastinum, and in left supraclavicular lymph nodes, which were correctly detected by F-FDG PET/CT. CONCLUSION: PET/CT with F-FDG provides additional value to TVUS for the differential diagnosis of benign from malignant pelvic lesions, and to CT for the staging of ovarian cancer patients.
AB - AIMS: To (a) assess the accuracy of F-FDG PET/CT in distinguishing malignant from benign pelvic lesions, compared to transvaginal ultrasonography (TVUS) and (b) to establish the role of whole-body F-FDG PET/CT, compared to contrast enhanced computed tomography (CT), in staging patients with ovarian cancer. PATIENTS: Fifty consecutive patients with a pelvic lesion, already scheduled for surgery on the basis of physical examination, TVUS, and serum Ca125 levels, were enrolled in the study. Patients' age ranged between 23 and 89 years (mean 64). All patients underwent TVUS including a colour Doppler study followed by a thorax and abdominal CT scan, and whole-body F-FDG PET/CT within 2 weeks prior to surgery. Histological findings obtained at surgery were taken as the 'gold standard' to compare F-FDG PET/CT and TVUS, and F-FDG PET/CT vs. CT. When tissue analysis showed ovarian cancer, the accuracy of F-FDG PET/CT and CT were compared for the purpose of obtaining a precise staging. RESULTS: At surgery, the ovarian lesions were malignant in 32/50 patients (64%) and benign in the remaining 18/50 patients (36%). The sensitivity, specificity, NPV, PPV and accuracy of F-FDG PET/CT were 87%, 100%, 81%, 100% and 92%, respectively, compared with 90%, 61%, 78%, 80% and 80%, respectively, for TVUS. In staging ovarian cancer, F-FDG PET/CT results were concordant with final pathological staging in 22/32 (69%) patients while CT results were concordant in 17/32 (53%) patients. CT incorrectly down-staged four out of six stage IV patients by missing distant metastasis in the liver, pleura, mediastinum, and in left supraclavicular lymph nodes, which were correctly detected by F-FDG PET/CT. CONCLUSION: PET/CT with F-FDG provides additional value to TVUS for the differential diagnosis of benign from malignant pelvic lesions, and to CT for the staging of ovarian cancer patients.
KW - F-FDG PET/CT
KW - Computed tomography (CT)
KW - Ovarian lesion
KW - Transvaginal ultrasonography (TVUS)
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UR - http://www.scopus.com/inward/citedby.url?scp=34447571766&partnerID=8YFLogxK
U2 - 10.1097/MNM.0b013e3281afa256
DO - 10.1097/MNM.0b013e3281afa256
M3 - Article
C2 - 17625380
AN - SCOPUS:34447571766
SN - 0143-3636
VL - 28
SP - 589
EP - 595
JO - Nuclear Medicine Communications
JF - Nuclear Medicine Communications
IS - 8
ER -