Document Detail


Recurrent ovarian cancer: use of contrast-enhanced CT and PET/CT to accurately localize tumor recurrence and to predict patients' survival.
MedLine Citation:
PMID:  20697116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare accuracy and interobserver variability in the detection and localization of recurrent ovarian cancer with contrast material-enhanced (CE) computed tomography (CT) and positron emission tomography (PET)/CT and determine whether imaging findings can be used to predict survival. MATERIALS AND METHODS: Waiving informed consent, the institutional review board approved this HIPAA-compliant, retrospective study of 35 women (median age, 54.4 years) with histopathologically proven recurrent ovarian carcinoma who underwent CE CT and PET/CT before exploratory surgery. All CE CT and PET/CT scans were independently analyzed. Tumor presence, number of lesions, and the size and maximum standardized uptake value (SUV(max)) of the largest lesion were recorded for patient and region. Surgical histopathologic findings constituted the reference standard. Areas under the receiver operating characteristic curves (AUCs), κ statistics, and hazard ratios were calculated. RESULTS: Readers' AUCs in detection of recurrence for region were 0.85 (95% confidence interval [CI]: 0.81, 0.90) and 0.78 (95% CI: 0.72, 0.83) for CE CT and 0.84 (95% CI: 0.79, 0.89) and 0.74 (95% CI: 0.67, 0.81) for PET/CT (P = .76); 12 patients died. At PET/CT, size, number, and SUV(max) of peritoneal deposits were significantly associated with poor survival for readers 1 and 2 (P ≤ .01and ≤ .05, respectively), as were long- and short-axis diameters, number, and SUV(max) of distant lymph nodes for reader 1 (P ≤ .001). With CE CT, size (reader 1) and number (readers 1 and 3) of peritoneal deposits were significantly associated with poor survival (P ≤ .01), as were long- and short-axis diameters and number of distant lymph nodes for reader 1 (P ≤ .01). Interobserver agreement ranged from fair (patient, κ = 0.30) to moderate (region, κ = 0.55) for CE CT and fair (patient, κ = 0.24) to substantial (region, κ = 0.63) for PET/CT. CONCLUSION: Preliminary data suggest that CE CT and PET/CT may have similar accuracy in detection of recurrent ovarian cancer. Tumor size, number, and SUV(max) may have potential as prognostic biomarkers for patients with recurrent ovarian cancer.
Authors:
Evis Sala; Masako Kataoka; Neeta Pandit-Taskar; Nicole Ishill; Svetlana Mironov; Chaya S Moskowitz; Oleg Mironov; Michelle A Collins; Dennis S Chi; Steven Larson; Hedvig Hricak
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-08-09
Journal Detail:
Title:  Radiology     Volume:  257     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  125-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, England. es220@radiol.cam.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Area Under Curve
Contrast Media / diagnostic use
Cross-Sectional Studies
Female
Humans
Lymphatic Metastasis
Middle Aged
Neoplasm Recurrence, Local / pathology,  radiography*,  radionuclide imaging*
Observer Variation
Ovarian Neoplasms / pathology,  radiography*,  radionuclide imaging*,  surgery
Positron-Emission Tomography / methods*
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media

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


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