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Erschienen in: Annals of Nuclear Medicine 9/2016

14.06.2016 | Original Article

Clinical usefulness of post-treatment FDG PET/CT in patients with ovarian malignancy

verfasst von: Eun Ji Han, Hye Lim Park, Yong Seok Lee, Eun Kyung Park, Min Jong Song, Ie Ryung Yoo, Sung Hoon Kim, Woo Hee Choi

Erschienen in: Annals of Nuclear Medicine | Ausgabe 9/2016

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Abstract

Objective

We aimed to evaluate the diagnostic and prognostic value of post-treatment fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients treated for ovarian malignancy.

Methods

We retrospectively reviewed post-treatment PET/CT images of patients treated for histologically confirmed ovarian malignancy. The diagnostic accuracy of PET/CT for detection of disease recurrence or second primary malignancy was calculated, and the impact of PET/CT on patient management was evaluated. The association between PET/CT result and overall survival (OS) was assessed using Cox regression analysis.

Results

In total, 416 PET/CT cases of 268 ovarian malignancy patients (mean age, 50 ± 13 years) were included. Of 416 cases, 87 (21 %) were interpreted as PET/CT positive and 329 as negative. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 98.8, 98.2, 98.3, 93.1 and 99.7 %, respectively. Of 362 cases for surveillance, changes in management occurred based on PET/CT in 38 (11 %). Of 54 cases with clinical suspicion, PET/CT ruled out disease recurrence in 9 (17 %). The median follow-up period from PET/CT imaging was 26.7 months, and 24 patients (9 %) died during the follow-up period. In univariate analyses, age, FIGO stage, history of prior recurrence and PET/CT results were significantly associated with OS. PET/CT results remained significantly associated with OS in the multivariate analysis (p < 0.05).

Conclusions

Post-treatment PET/CT was a useful modality for the detection of disease recurrence or second primary malignancy that could improve the likelihood of proper treatment and help predict outcome in patients with ovarian malignancy.
Literatur
2.
Zurück zum Zitat Lowe KA, Chia VM, Taylor A, O’Malley C, Kelsh M, Mohamed M, et al. An international assessment of ovarian cancer incidence and mortality. Gynecol Oncol. 2013;130:107–14.CrossRefPubMed Lowe KA, Chia VM, Taylor A, O’Malley C, Kelsh M, Mohamed M, et al. An international assessment of ovarian cancer incidence and mortality. Gynecol Oncol. 2013;130:107–14.CrossRefPubMed
3.
Zurück zum Zitat Armstrong DK. Relapsed ovarian cancer: challenges and management strategies for a chronic disease. Oncologist. 2002;7(Suppl 5):20–8.CrossRefPubMed Armstrong DK. Relapsed ovarian cancer: challenges and management strategies for a chronic disease. Oncologist. 2002;7(Suppl 5):20–8.CrossRefPubMed
4.
Zurück zum Zitat Gadducci A, Cosio S, Zola P, Landoni F, Maggino T, Sartori E. Surveillance procedures for patients treated for epithelial ovarian cancer: a review of the literature. Int J Gynecol Cancer. 2007;17:21–31.CrossRefPubMed Gadducci A, Cosio S, Zola P, Landoni F, Maggino T, Sartori E. Surveillance procedures for patients treated for epithelial ovarian cancer: a review of the literature. Int J Gynecol Cancer. 2007;17:21–31.CrossRefPubMed
7.
Zurück zum Zitat Han EJ, Yang YJ, Park JC, Park SY, Choi WH, Kim SH. Prognostic value of early response assessment using 18F-FDG PET/CT in chemotherapy-treated patients with non-small-cell lung cancer. Nucl Med Commun. 2015;36:1187–94.CrossRefPubMed Han EJ, Yang YJ, Park JC, Park SY, Choi WH, Kim SH. Prognostic value of early response assessment using 18F-FDG PET/CT in chemotherapy-treated patients with non-small-cell lung cancer. Nucl Med Commun. 2015;36:1187–94.CrossRefPubMed
8.
Zurück zum Zitat Risum S, Hogdall C, Loft A, Berthelsen AK, Hogdall E, Nedergaard L, et al. Prediction of suboptimal primary cytoreduction in primary ovarian cancer with combined positron emission tomography/computed tomography—a prospective study. Gynecol Oncol. 2008;108:265–70.CrossRefPubMed Risum S, Hogdall C, Loft A, Berthelsen AK, Hogdall E, Nedergaard L, et al. Prediction of suboptimal primary cytoreduction in primary ovarian cancer with combined positron emission tomography/computed tomography—a prospective study. Gynecol Oncol. 2008;108:265–70.CrossRefPubMed
9.
Zurück zum Zitat Yoshida Y, Kurokawa T, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, et al. Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer. AJR Am J Roentgenol. 2004;182:227–33.CrossRefPubMed Yoshida Y, Kurokawa T, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, et al. Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer. AJR Am J Roentgenol. 2004;182:227–33.CrossRefPubMed
10.
Zurück zum Zitat Schwarz JK, Grigsby PW, Dehdashti F, Delbeke D. The role of 18F-FDG PET in assessing therapy response in cancer of the cervix and ovaries. J Nucl Med. 2009;50(Suppl 1):64S–73S.CrossRefPubMed Schwarz JK, Grigsby PW, Dehdashti F, Delbeke D. The role of 18F-FDG PET in assessing therapy response in cancer of the cervix and ovaries. J Nucl Med. 2009;50(Suppl 1):64S–73S.CrossRefPubMed
11.
Zurück zum Zitat Oh SW, Kim SK. Clinical application of 18F-FDG PET in ovarian cancer. Nucl Med Mol Imaging. 2008;42(Suppl 1):91–100. Oh SW, Kim SK. Clinical application of 18F-FDG PET in ovarian cancer. Nucl Med Mol Imaging. 2008;42(Suppl 1):91–100.
12.
Zurück zum Zitat Rose PG, Faulhaber P, Miraldi F, Abdul-Karim FW. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol. 2001;82:17–21.CrossRefPubMed Rose PG, Faulhaber P, Miraldi F, Abdul-Karim FW. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol. 2001;82:17–21.CrossRefPubMed
13.
Zurück zum Zitat Cho SM, Ha HK, Byun JY, Lee JM, Kim CJ, Nam-Koong SE, et al. Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer. AJR Am J Roentgenol. 2002;179:391–5.CrossRefPubMed Cho SM, Ha HK, Byun JY, Lee JM, Kim CJ, Nam-Koong SE, et al. Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer. AJR Am J Roentgenol. 2002;179:391–5.CrossRefPubMed
14.
Zurück zum Zitat Rohren EM, Dillehay GL, Jadvar H. SNMMI comment on ASCO 2013 “Choosing wisely” recommendation on use of PET/CT in recurrent cancer surveillance. J Nucl Med. 2014;55:699–700.CrossRefPubMed Rohren EM, Dillehay GL, Jadvar H. SNMMI comment on ASCO 2013 “Choosing wisely” recommendation on use of PET/CT in recurrent cancer surveillance. J Nucl Med. 2014;55:699–700.CrossRefPubMed
15.
Zurück zum Zitat Antoniou AJ, Marcus C, Tahari AK, Wahl RL, Subramaniam RM. Follow-up or surveillance (18)F-FDG PET/CT and survival outcome in lung cancer patients. J Nucl Med. 2014;55:1062–8.CrossRefPubMedPubMedCentral Antoniou AJ, Marcus C, Tahari AK, Wahl RL, Subramaniam RM. Follow-up or surveillance (18)F-FDG PET/CT and survival outcome in lung cancer patients. J Nucl Med. 2014;55:1062–8.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Kim JW, Roh JL, Kim JS, Lee JH, Cho KJ, Choi SH, et al. (18)F-FDG PET/CT surveillance at 3–6 and 12 months for detection of recurrence and second primary cancer in patients with head and neck squamous cell carcinoma. Br J Cancer. 2013;109:2973–9.CrossRefPubMedPubMedCentral Kim JW, Roh JL, Kim JS, Lee JH, Cho KJ, Choi SH, et al. (18)F-FDG PET/CT surveillance at 3–6 and 12 months for detection of recurrence and second primary cancer in patients with head and neck squamous cell carcinoma. Br J Cancer. 2013;109:2973–9.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Hosmer DW, Lemeshow S, May S. Applied survival analysis: regression modeling of time to event data. 2nd ed. New York: Wiley; 2008.CrossRef Hosmer DW, Lemeshow S, May S. Applied survival analysis: regression modeling of time to event data. 2nd ed. New York: Wiley; 2008.CrossRef
18.
Zurück zum Zitat Machin D, Cheung YB, Parmar MKB. Survival analysis: a practical approach. 2nd ed. New York: Wiley; 2006.CrossRef Machin D, Cheung YB, Parmar MKB. Survival analysis: a practical approach. 2nd ed. New York: Wiley; 2006.CrossRef
19.
Zurück zum Zitat Drieskens O, Stroobants S, Gysen M, Vandenbosch G, Mortelmans L, Vergote I. Positron emission tomography with FDG in the detection of peritoneal and retroperitoneal metastases of ovarian cancer. Gynecol Obstet Invest. 2003;55:130–4.CrossRefPubMed Drieskens O, Stroobants S, Gysen M, Vandenbosch G, Mortelmans L, Vergote I. Positron emission tomography with FDG in the detection of peritoneal and retroperitoneal metastases of ovarian cancer. Gynecol Obstet Invest. 2003;55:130–4.CrossRefPubMed
20.
Zurück zum Zitat Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. AJR Am J Roentgenol. 2001;176:1449–54.CrossRefPubMed Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. AJR Am J Roentgenol. 2001;176:1449–54.CrossRefPubMed
21.
Zurück zum Zitat Kapoor V, McCook BM, Torok FS. An introduction to PET-CT imaging. Radiographics. 2004;24:523–43.CrossRefPubMed Kapoor V, McCook BM, Torok FS. An introduction to PET-CT imaging. Radiographics. 2004;24:523–43.CrossRefPubMed
22.
Zurück zum Zitat Griffeth LK. Use of PET/CT scanning in cancer patients: technical and practical considerations. Proc (Bayl Univ Med Cent). 2005;18:321–30. Griffeth LK. Use of PET/CT scanning in cancer patients: technical and practical considerations. Proc (Bayl Univ Med Cent). 2005;18:321–30.
23.
Zurück zum Zitat Iagaru AH, Mittra ES, McDougall IR, Quon A, Gambhir SS. 18F-FDG PET/CT evaluation of patients with ovarian carcinoma. Nucl Med Commun. 2008;29:1046–51.CrossRefPubMedPubMedCentral Iagaru AH, Mittra ES, McDougall IR, Quon A, Gambhir SS. 18F-FDG PET/CT evaluation of patients with ovarian carcinoma. Nucl Med Commun. 2008;29:1046–51.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Nanni C, Rubello D, Farsad M, De Iaco P, Sansovini M, Erba P, et al. (18)F-FDG PET/CT in the evaluation of recurrent ovarian cancer: a prospective study on 41 patients. Eur J Surg Oncol. 2005;31:792–7.CrossRefPubMed Nanni C, Rubello D, Farsad M, De Iaco P, Sansovini M, Erba P, et al. (18)F-FDG PET/CT in the evaluation of recurrent ovarian cancer: a prospective study on 41 patients. Eur J Surg Oncol. 2005;31:792–7.CrossRefPubMed
25.
Zurück zum Zitat Evangelista L, Palma MD, Gregianin M, Nardin M, Roma A, Nicoletto MO, et al. Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients. J Turk Ger Gynecol Assoc. 2015;16:137–44.CrossRefPubMedPubMedCentral Evangelista L, Palma MD, Gregianin M, Nardin M, Roma A, Nicoletto MO, et al. Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients. J Turk Ger Gynecol Assoc. 2015;16:137–44.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Takeuchi S, Lucchini M, Schmeler KM, Coleman RL, Gershenson DM, Munsell MF, et al. Utility of 18F-FDG PET/CT in follow-up of patients with low-grade serous carcinoma of the ovary. Gynecol Oncol. 2014;133:100–4.CrossRefPubMedPubMedCentral Takeuchi S, Lucchini M, Schmeler KM, Coleman RL, Gershenson DM, Munsell MF, et al. Utility of 18F-FDG PET/CT in follow-up of patients with low-grade serous carcinoma of the ovary. Gynecol Oncol. 2014;133:100–4.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Palomar A, Nanni C, Castellucci P, Ambrosini V, Montini GC, Allegri V, et al. Value of FDG PET/CT in patients with treated ovarian cancer and raised CA125 serum levels. Mol Imaging Biol. 2012;14:123–9.CrossRefPubMed Palomar A, Nanni C, Castellucci P, Ambrosini V, Montini GC, Allegri V, et al. Value of FDG PET/CT in patients with treated ovarian cancer and raised CA125 serum levels. Mol Imaging Biol. 2012;14:123–9.CrossRefPubMed
28.
Zurück zum Zitat Kim CY, Jeong SY, Chong GO, Son SH, Jung JH, Kim DH, et al. Quantitative metabolic parameters measured on F-18 FDG PET/CT predict survival after relapse in patients with relapsed epithelial ovarian cancer. Gynecol Oncol. 2015;136:498–504.CrossRefPubMed Kim CY, Jeong SY, Chong GO, Son SH, Jung JH, Kim DH, et al. Quantitative metabolic parameters measured on F-18 FDG PET/CT predict survival after relapse in patients with relapsed epithelial ovarian cancer. Gynecol Oncol. 2015;136:498–504.CrossRefPubMed
29.
Zurück zum Zitat Hebel CB, Behrendt FF, Heinzel A, Krohn T, Mottaghy FM, Bauerschlag DO, et al. Negative 18F-2-fluorodeoxyglucose PET/CT predicts good cancer specific survival in patients with a suspicion of recurrent ovarian cancer. Eur J Radiol. 2014;83:463–7.CrossRefPubMed Hebel CB, Behrendt FF, Heinzel A, Krohn T, Mottaghy FM, Bauerschlag DO, et al. Negative 18F-2-fluorodeoxyglucose PET/CT predicts good cancer specific survival in patients with a suspicion of recurrent ovarian cancer. Eur J Radiol. 2014;83:463–7.CrossRefPubMed
Metadaten
Titel
Clinical usefulness of post-treatment FDG PET/CT in patients with ovarian malignancy
verfasst von
Eun Ji Han
Hye Lim Park
Yong Seok Lee
Eun Kyung Park
Min Jong Song
Ie Ryung Yoo
Sung Hoon Kim
Woo Hee Choi
Publikationsdatum
14.06.2016
Verlag
Springer Japan
Erschienen in
Annals of Nuclear Medicine / Ausgabe 9/2016
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-016-1100-0

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