Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2011

01.02.2011 | Gynecologic Oncology

Combined positron emission tomography–computed tomography and tumor markers for detecting recurrent ovarian cancer

verfasst von: Hun-Shan Pan, Shiow-Lin Lee, Lee-Wen Huang, Yen-Kung Chen

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate the accuracy of integrated FDG-PET/CT and tumor markers for the depiction of recurrent ovarian carcinoma.

Methods

Patients with pathologically proven ovarian cancer, who underwent cytoreductive surgery and 3–6 cycles of adjuvant chemotherapy, were included in this study. They all underwent a thorough physical examination, tumor marker determination, and FDG-PET/CT imaging. The sensitivity, specificity, accuracy, and positive and negative predictive values for the tumor detection with PET/CT versus different tumor markers were performed in relation to the results at histological analysis after second-look surgery or clinical follow-up.

Results

A total of 37 patients underwent FDG-PET/CT scans. Among them, 22 patients underwent exploratory laparotomy and 15 had diagnostic laparoscopy. Overall, 24 patients were documented to have ovarian cancer recurrence after second operation. FDG-PET/CT had sensitivity, specificity, accuracy, and positive and negative predictive values of 100, 85, 94, 92, and 100%, respectively.

Conclusion

Our study has shown that PET/CT is a sensitive tool to assist in the early identification and recurrent ovarian cancer, amenable to secondary cytoreduction.
Literatur
2.
Zurück zum Zitat Garcia-Veloso MJ, Jurado M, Ceamanos C, Aramendia JM, Garrastachu MP, Lopez-Garcia G, Richer JA (2007) Diagnostic accuracy of FDG PET in the follow-up of platinum sensitive epithelial ovarian carcinoma. Eur J Nuc Med Mol Imaging 34:1396–1405CrossRef Garcia-Veloso MJ, Jurado M, Ceamanos C, Aramendia JM, Garrastachu MP, Lopez-Garcia G, Richer JA (2007) Diagnostic accuracy of FDG PET in the follow-up of platinum sensitive epithelial ovarian carcinoma. Eur J Nuc Med Mol Imaging 34:1396–1405CrossRef
3.
Zurück zum Zitat Gu P, Pan LL, Wu SQ, Sun L, Huang G (2007) CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systemic review and meta-analysis. J Clin Lab Anal 21:398–405CrossRefPubMed Gu P, Pan LL, Wu SQ, Sun L, Huang G (2007) CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systemic review and meta-analysis. J Clin Lab Anal 21:398–405CrossRefPubMed
4.
Zurück zum Zitat Rustin CJ, Nelstrop AE, Tuxen MK, Lamber HE (1996) Defining progression of ovarian carcinoma during follow-up according to CA 125: a North Thames Ovary Group Study. Ann Oncol 7:361–364PubMed Rustin CJ, Nelstrop AE, Tuxen MK, Lamber HE (1996) Defining progression of ovarian carcinoma during follow-up according to CA 125: a North Thames Ovary Group Study. Ann Oncol 7:361–364PubMed
5.
Zurück zum Zitat Santillan A, Garg R, Zahurak ML, Gardner GJ, Giuntoli RL, Armstrong DK, Bristow RE (2005) Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range. J Clin Oncol 23:9338–9343CrossRefPubMed Santillan A, Garg R, Zahurak ML, Gardner GJ, Giuntoli RL, Armstrong DK, Bristow RE (2005) Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range. J Clin Oncol 23:9338–9343CrossRefPubMed
6.
Zurück zum Zitat Engelen ML, de Bruijn HW, Hollwema H, ten Hoor KA, Willemse PH, Aalders JG, van der Zee AG (2000) Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors. Gynecol Oncol 78:16–20CrossRefPubMed Engelen ML, de Bruijn HW, Hollwema H, ten Hoor KA, Willemse PH, Aalders JG, van der Zee AG (2000) Serum CA 125, carcinoembryonic antigen, and CA 19-9 as tumor markers in borderline ovarian tumors. Gynecol Oncol 78:16–20CrossRefPubMed
7.
Zurück zum Zitat Motoyama T, Watanabe H, Takeuchi S, Watanabe T, Gotoh S, Okazaki E (1990) Cancer antigen 125, carcinoembryonic antigen and carbohydrate determinant 19-9 in ovarian tumors. Cancer 66:2628–2635 Motoyama T, Watanabe H, Takeuchi S, Watanabe T, Gotoh S, Okazaki E (1990) Cancer antigen 125, carcinoembryonic antigen and carbohydrate determinant 19-9 in ovarian tumors. Cancer 66:2628–2635
8.
Zurück zum Zitat Ak I, Stokkel MPM, Pauwels EJK (2000) Positron emission tomography with 2-[18F]fluoro-2-deoxy-d-glucose in oncology. J Cancer Res Clin Oncol 126:560–574CrossRefPubMed Ak I, Stokkel MPM, Pauwels EJK (2000) Positron emission tomography with 2-[18F]fluoro-2-deoxy-d-glucose in oncology. J Cancer Res Clin Oncol 126:560–574CrossRefPubMed
9.
Zurück zum Zitat Nakamoto Y, Saga T, Fujii S (2005) Positron emission tomography application for gynecologic tumors. Int J Gynecol Cancer 15(5):701–709 Nakamoto Y, Saga T, Fujii S (2005) Positron emission tomography application for gynecologic tumors. Int J Gynecol Cancer 15(5):701–709
10.
Zurück zum Zitat Cho SM, Ha HK, Byun JY, Lee JM, Kin CJ, Nam-Kong SE, Lee JM (2002) Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer. Am J Roentgenol 179(2):391–395 Cho SM, Ha HK, Byun JY, Lee JM, Kin CJ, Nam-Kong SE, Lee JM (2002) Usefulness of FDG PET for assessment of early recurrent epithelial ovarian cancer. Am J Roentgenol 179(2):391–395
11.
Zurück zum Zitat Makhija S, Howden N, Edwards R, Kelley J, Townsend DW, Meltzer CC (2002) Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a retrospective review. Gynecol Oncol 85:53–58CrossRefPubMed Makhija S, Howden N, Edwards R, Kelley J, Townsend DW, Meltzer CC (2002) Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a retrospective review. Gynecol Oncol 85:53–58CrossRefPubMed
12.
Zurück zum Zitat Bristow RE, Giuntoli RL, Pannu HK, Schulick RD, Fishman EK, Wahl RL (2005) Combined PET/CT for detecting recurrent ovarian cancer limited to retroperitoneal lymph nodes. Gynecol Oncol 99:294–300CrossRefPubMed Bristow RE, Giuntoli RL, Pannu HK, Schulick RD, Fishman EK, Wahl RL (2005) Combined PET/CT for detecting recurrent ovarian cancer limited to retroperitoneal lymph nodes. Gynecol Oncol 99:294–300CrossRefPubMed
13.
Zurück zum Zitat Thrall MM, DeLoia JA, Gallion H, Avril N (2007) Clinical use of combined positron emission tomography and computed tomography (FDG-PET/CT) in recurrent ovarian cancer. Gynecol Oncol 105:17–22CrossRefPubMed Thrall MM, DeLoia JA, Gallion H, Avril N (2007) Clinical use of combined positron emission tomography and computed tomography (FDG-PET/CT) in recurrent ovarian cancer. Gynecol Oncol 105:17–22CrossRefPubMed
14.
Zurück zum Zitat National Institutes of Health (1994) Ovarian cancer: screening, treatment and follow-up. NIH Consensus Statement 1994, vol 12, pp 1–30 National Institutes of Health (1994) Ovarian cancer: screening, treatment and follow-up. NIH Consensus Statement 1994, vol 12, pp 1–30
15.
Zurück zum Zitat Meyer T, Rustin GJS (2000) Role of tumor markers in monitoring epithelial ovarian cancer. Br J Cancer 83:1535–1538 Meyer T, Rustin GJS (2000) Role of tumor markers in monitoring epithelial ovarian cancer. Br J Cancer 83:1535–1538
16.
Zurück zum Zitat Sugiyama T, Nishida T, Komai K et al (1996) Comparison of CA 125 assays with abdominopelvic computed tomography and transvaginal ultrasound in monitoring of ovarian cancer. Int J Gynecol Obstet 54:251–256CrossRef Sugiyama T, Nishida T, Komai K et al (1996) Comparison of CA 125 assays with abdominopelvic computed tomography and transvaginal ultrasound in monitoring of ovarian cancer. Int J Gynecol Obstet 54:251–256CrossRef
17.
Zurück zum Zitat Ferazzi E, Zanetta G, Dordoni D, Berlanda N, Mezzopane R, Lissoni AA et al (1997) Transvaginal ultrasonographic characterization of ovarian masses: comparison of five scoring system in multicenter study. Ultrasound Obstet Gynecol 10:192–197CrossRef Ferazzi E, Zanetta G, Dordoni D, Berlanda N, Mezzopane R, Lissoni AA et al (1997) Transvaginal ultrasonographic characterization of ovarian masses: comparison of five scoring system in multicenter study. Ultrasound Obstet Gynecol 10:192–197CrossRef
18.
Zurück zum Zitat Forstner R, Hricak H, Powell CB et al (1995) Ovarian cancer recurrence: value of MR imaging. Radiology 196:715–720PubMed Forstner R, Hricak H, Powell CB et al (1995) Ovarian cancer recurrence: value of MR imaging. Radiology 196:715–720PubMed
19.
Zurück zum Zitat Kim CK, Park BK, Choi JY, Kim BG, Han H (2007) Detection of recurrent ovarian cancer at MRI: comparison with integrated PET/CT. J Comput Assist Tomogr 31:868–875CrossRefPubMed Kim CK, Park BK, Choi JY, Kim BG, Han H (2007) Detection of recurrent ovarian cancer at MRI: comparison with integrated PET/CT. J Comput Assist Tomogr 31:868–875CrossRefPubMed
20.
Zurück zum Zitat De Rosa V, Mangoni de Stefano ML, Brunetti A et al (1995) Computer tomography and second look surgery in ovarian cancer patient: correlation, actual role and limitations of CT scan. Eur J Gynecol Concol 16:123–129 De Rosa V, Mangoni de Stefano ML, Brunetti A et al (1995) Computer tomography and second look surgery in ovarian cancer patient: correlation, actual role and limitations of CT scan. Eur J Gynecol Concol 16:123–129
21.
Zurück zum Zitat Bristow RE, del Carmen MG, Pannu HK, Cohade C, Zahurak ML, Fishman EK, Wahl RL, Montz FJ (2003) Clinically occult recurrent ovarian cancer: patient selection for secondary cytoreductive surgery using combined PET/CT. Gynecol Oncol 20:519–528CrossRef Bristow RE, del Carmen MG, Pannu HK, Cohade C, Zahurak ML, Fishman EK, Wahl RL, Montz FJ (2003) Clinically occult recurrent ovarian cancer: patient selection for secondary cytoreductive surgery using combined PET/CT. Gynecol Oncol 20:519–528CrossRef
22.
Zurück zum Zitat Jimenez-Bonilla J, Maldonado A, Morales S, Salud A, Zomeno M, Roman J, Bolen J, Moya F (2000) Clinical impact of 18F-FDG-PET in the suspicion of recurrent ovarian carcinoma based on elevated tumor marker serum levels. Clin Positron Imaging 3:231–236CrossRefPubMed Jimenez-Bonilla J, Maldonado A, Morales S, Salud A, Zomeno M, Roman J, Bolen J, Moya F (2000) Clinical impact of 18F-FDG-PET in the suspicion of recurrent ovarian carcinoma based on elevated tumor marker serum levels. Clin Positron Imaging 3:231–236CrossRefPubMed
23.
Zurück zum Zitat Murakami M, Miyamoto T, Iida T, Tsukada M, Watanabe M, Shida M, Maeda H, Nasu S, Yasuda S, Yasuda M, Ide M (2006) Whole body positron emission tomography and tumor marker CA 125 for detection of recurrence in epithelial ovarian cancer. Int J Gynecol Cancer 16(Suppl 1):99–107CrossRefPubMed Murakami M, Miyamoto T, Iida T, Tsukada M, Watanabe M, Shida M, Maeda H, Nasu S, Yasuda S, Yasuda M, Ide M (2006) Whole body positron emission tomography and tumor marker CA 125 for detection of recurrence in epithelial ovarian cancer. Int J Gynecol Cancer 16(Suppl 1):99–107CrossRefPubMed
24.
Zurück zum Zitat Takekuma M, Maeda M, Ozawa T, Yasumi K, Torizuka T (2005) Positron emission tomography with 18F-fluoro-2-deoxyglucose for the detection of recurrent ovarian cancer. Int J Clin Oncol 10:17–81CrossRef Takekuma M, Maeda M, Ozawa T, Yasumi K, Torizuka T (2005) Positron emission tomography with 18F-fluoro-2-deoxyglucose for the detection of recurrent ovarian cancer. Int J Clin Oncol 10:17–81CrossRef
25.
Zurück zum Zitat Rubin SC, Hoskins WJ, Hakes TB, Markman M, Reichman BS, Chapman D, Lewis JL (1989) Serum CA 125 levels and surgical findings in patients undergoing secondary operations for epithelial ovarian cancer. Am J Obstet Gynecol 160:667–671PubMed Rubin SC, Hoskins WJ, Hakes TB, Markman M, Reichman BS, Chapman D, Lewis JL (1989) Serum CA 125 levels and surgical findings in patients undergoing secondary operations for epithelial ovarian cancer. Am J Obstet Gynecol 160:667–671PubMed
26.
Zurück zum Zitat Chung HH, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, Kang SB, Lee HP (2007) Role of [18F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clinical or histological findings. Eur J Nucl Med mol Imaging 34:480–486CrossRefPubMed Chung HH, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, Kang SB, Lee HP (2007) Role of [18F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clinical or histological findings. Eur J Nucl Med mol Imaging 34:480–486CrossRefPubMed
Metadaten
Titel
Combined positron emission tomography–computed tomography and tumor markers for detecting recurrent ovarian cancer
verfasst von
Hun-Shan Pan
Shiow-Lin Lee
Lee-Wen Huang
Yen-Kung Chen
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1404-6

Weitere Artikel der Ausgabe 2/2011

Archives of Gynecology and Obstetrics 2/2011 Zur Ausgabe

Ambulantisierung: Erste Erfahrungen mit dem Hybrid-DRG

02.05.2024 DCK 2024 Kongressbericht

Die Hybrid-DRG-Verordnung soll dazu führen, dass mehr chirurgische Eingriffe ambulant durchgeführt werden, wie es in anderen Ländern schon länger üblich ist. Die gleiche Vergütung im ambulanten und stationären Sektor hatten Niedergelassene schon lange gefordert. Aber die Umsetzung bereitet ihnen doch Kopfzerbrechen.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Harninkontinenz: Netz-Op. erfordert über lange Zeit intensive Nachsorge

30.04.2024 Harninkontinenz Nachrichten

Frauen mit Belastungsinkontinenz oder Organprolaps sind nach einer Netz-Operation keineswegs beschwerdefrei. Vielmehr scheint die Krankheitslast weiterhin hoch zu sein, sogar höher als von harninkontinenten Frauen, die sich nicht haben operieren lassen.

Welche Übungen helfen gegen Diastase recti abdominis?

30.04.2024 Schwangerenvorsorge Nachrichten

Die Autorinnen und Autoren einer aktuellen Studie aus Griechenland sind sich einig, dass Bewegungstherapie, einschließlich Übungen zur Stärkung der Bauchmuskulatur und zur Stabilisierung des Rumpfes, eine Diastase recti abdominis postpartum wirksam reduzieren kann. Doch vieles ist noch nicht eindeutig belegt.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.