Document Detail


Advanced ovarian carcinoma: usefulness of [(18)F]FDG-PET in combination with CT for lesion detection after primary treatment.
MedLine Citation:
PMID:  12865867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine the additional value of [(18)F]FDG-PET in combination with computed tomography (CT) over CT used alone, for evaluating ovarian cancer patients after primary treatment. METHODS: Twenty-five women (mean age: 53.6 years) had primary debulking surgery followed by chemotherapy for histologically proven ovarian carcinoma. At initial diagnosis, the tumor types were papillary serous adenocarcinoma (n=20), endometroid carcinoma (n=3), mixed mullerian tumor (n=1), and granulosa cell tumor (n=1). All patients underwent [(18)F]FDG-PET and contrast enhanced CT examinations, within 30 days of the completion of chemotherapic treatment. [(18)F]FDG-PET images were interpreted with the knowledge of CT findings (PET+CT); conversely, CT images were evaluated with no knowledge of the [(18)F]FDG-PET results. Within 7 day of imaging studies, 2(nd)-look laparoscopy (n=7) or laparotomy (n=18) was performed for histological confirmation. In all cases, imaging findings were then correlated with results of histopathologic examination. RESULTS: Of the 23 neoplastic viable lesions, all histologically confirmed, 16 could be detected by CT alone and 19 by PET+CT. An inflammatory lymph-node was misdiagnosed as viable tumor with both PET+CT and CT alone; an area of scar tissue in the presacral region was also misinterpreted as malignant tissue with CT alone. Overall lesion-based sensitivity, specificity and accuracy in assessing focal areas of residual tumor were as follows: 69.56%, 83.33%, 74.28% for CT, and 82.60%, 91.67%, 85.71% for PET+CT. The negative predictive value of PET+CT was markedly higher (73.33%), compared to that of CT alone (58.82%). CONCLUSION: PET used in combination with CT allows to accurately assess tumor response. A major advantage of PET+CT over CT alone is in excluding the presence of residual viable lesions after treatment.
Authors:
M Picchio; S Sironi; C Messa; G Mangili; C Landoni; L Gianolli; B Zangheri; R Viganò; G Aletti; P De Marzi; F De Cobelli; A Del Maschio; A Ferrari; F Fazio
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR)     Volume:  47     ISSN:  1125-0135     ISO Abbreviation:  Q J Nucl Med     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-07-16     Completed Date:  2004-05-17     Revised Date:  2007-01-10    
Medline Journal Info:
Nlm Unique ID:  9512274     Medline TA:  Q J Nucl Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  77-84     Citation Subset:  IM    
Affiliation:
IBFM-CNR, University of Milano-Bicocca, University of Vita-Salute, Institute H. San Raffaele, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Middle Aged
Neoplasm Recurrence, Local / radiography*,  radionuclide imaging*
Ovarian Neoplasms / diagnosis*,  radiography,  radionuclide imaging,  therapy*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique*
Tomography, Emission-Computed / methods*
Tomography, X-Ray Computed / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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