Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: Comparison with enhanced CT

Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Yasushi Kaji, Ichio Fukasawa, Noriyuki Inaba, Kazuro Sugimura

Research output: Contribution to journalReview article

121 Citations (Scopus)

Abstract

Purpose: The purpose of the study is to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) with IV contrast for preoperative staging of ovarian cancer, in comparison with enhanced CT, using surgical and histopathological findings as the reference standard. Materials and methods: Forty patients with ovarian cancer underwent FDG-PET/contrast-enhanced CT scans for staging before primary debulking surgery. PET/CT and the CT component separately, were interpreted by two experienced radiologists by consensus for each investigation. Status with regard to lesion inside and outside the pelvis was determined on the basis of histopathology. The significance of differences between the two imaging modalities was determined using the McNemar test. Results: Staging revealed stage I in 18 patients (IA, n=9; IB, n=3; IC, n=6), stage II in seven (IIA, n=2; IIB, n=3; IIC, n=2), stage III in 14 (IIIA, n=1; IIIB, n=3; IIIC, n=10), and stage IV in one. The results of CT and PET/CT were concordant with the final pathological staging in 22 out of 40 (55%) and 30 out of 40 (75%) cases, respectively. The overall lesion-based sensitivity improved from 37.6% (32 out of 85) to 69.4% (59 out of 85), specificity from 97.1% (578 out of 595) to 97.5% (580 out of 595), and accuracy from 89.7% (610 out of 680) to 94.0% (639 out of 680) between CT and PET/CT. There were significant differences in sensitivity and accuracy, with p values of 5.6×10 -7 and 1.2×10-7, respectively. Conclusion: Integrated FDG-PET/contrast-enhanced CT is a more accurate imaging modality for staging ovarian cancer and useful for selecting appropriate treatment than enhanced CT.

Original languageEnglish
Pages (from-to)1912-1920
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume35
Issue number10
DOIs
Publication statusPublished - 2008 Oct 1

Keywords

  • F-FDG
  • Ovarian cancer
  • PET/CT
  • Staging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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