Document Detail


Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer: correlation with transvaginal ultrasonography, computed tomography, and histology.
MedLine Citation:
PMID:  17625380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To (a) assess the accuracy of 18F-FDG PET/CT in distinguishing malignant from benign pelvic lesions, compared to transvaginal ultrasonography (TVUS) and (b) to establish the role of whole-body 18F-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 18F-FDG PET/CT within 2 weeks prior to surgery. Histological findings obtained at surgery were taken as the 'gold standard' to compare 18F-FDG PET/CT and TVUS, and 18F-FDG PET/CT vs. CT. When tissue analysis showed ovarian cancer, the accuracy of 18F-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 18F-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, 18F-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 18F-FDG PET/CT. CONCLUSION: PET/CT with 18F-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.
Authors:
Paolo Castellucci; Anna M Perrone; Maria Picchio; Tullio Ghi; Mohsen Farsad; Cristina Nanni; Cristina Messa; Maria C Meriggiola; Giuseppe Pelusi; Adil Al-Nahhas; Domenico Rubello; Ferruccio Fazio; Stefano Fanti
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  28     ISSN:  0143-3636     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-12     Completed Date:  2007-08-30     Revised Date:  2008-09-03    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  England    
Other Details:
Languages:  eng     Pagination:  589-95     Citation Subset:  IM    
Affiliation:
Nuclear Medicine Department, Policlinico Sant'Orsola Malpighi, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Middle Aged
Neoplasm Staging
Ovarian Diseases / diagnosis
Ovarian Neoplasms / diagnosis*,  pathology
Positron-Emission Tomography*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Sensitivity and Specificity
Tomography, X-Ray Computed*
Ultrasonography, Doppler, Color
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections
Comment In:
Nucl Med Commun. 2007 Nov;28(11):879-80; author reply 880   [PMID:  17901773 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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