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Clinical Value of Positron Emission Tomography with FDG for Recurrent Ovarian Cancer

¹ Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto, 606-8507 Japan.
² Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University Hospital, Kyoto, 606-8507 Japan.
³ Department of Radiology, Hamamatsu University School of Medicine, 3600 Handa, Hamamatsu, 431-3192 Japan.

OBJECTIVE. Recurrence is often a major problem for patients who have undergone surgery for ovarian cancer. This prospective study was undertaken to evaluate the clinical contribution of positron emission tomography (PET) using ¹⁸F-fluorodeoxyglucose (FDG) for recurrent ovarian cancer.

SUBJECTS AND METHODS. Twenty-four women who had undergone surgery or chemoradiotherapy for histopathologically proven ovarian cancer were enrolled in this study. Ovarian cancer was thought to have recurred in 12 of these women because of evidence on conventional imaging modalities or tumor marker measurements (group A). Clinical findings for the remaining 12 women showed them to be disease-free (group B). PET findings for the women were compared with the final diagnoses obtained by histopathology or by clinical follow-up. The clinical contribution of PET was assessed by evaluating whether PET yielded information complementing the findings of conventional modalities and by examining its impact on treatment.

RESULTS. PET gave valuable information for seven of 12 patients in group A in addition to the information obtained from findings on conventional imaging, and treatment was affected in five patients. On the other hand, in group B, additional information was obtained in only three of 12 patients, and treatment of only one patient was affected. Overall sensitivity, specificity, and accuracy of conventional imaging modalities were 72.7%, 75.0%, and 73.3%, respectively, and these rates improved to 92.3%, 100.0%, and 94.4%, respectively, by considering both conventional imaging modalities and PET findings.

CONCLUSION. Our preliminary data suggest that whole-body PET with FDG can be a complementary modality for following up patients who have had ovarian cancer, especially patients believed to be at risk for recurrence.

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