Diagnostic accuracy of18F-FDG PET/CT in the evaluation of recurrent ovarian cancer

  • Norazlina Mat Nawi Department of Nuclear Medicine, Radiotherapy & Oncology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kota Bharu, Kelantan, Malaysia
  • Irfan Mohamad Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kota Bharu, Kelantan, Malaysia
  • Mohamed Ali Abdul Khader Department of Nuclear Medicine, Penang Hospital, Jalan Residensi, 10990 George Town, Penang, Malaysia
  • Ibrahim Lutfi Shuaib Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang, Malaysia
Keywords: Ovarian neoplasms; Recurrence; Positron-emission Tomography; Computed tomography; CA-125 antigen

Abstract

Objective: Ovarian cancer recurrence is often a major problem for patients who have undergone treatment. This prospective study was undertaken to evaluate the diagnostic accuracy of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG)/ computed tomography (CT) in patients with suspected for ovarian cancer recurrence.

Methods: A total of 43 women who underwent surgery or chemotherapy for ovarian cancer were enrolled in this study. They underwent18 F-FDG PET/CT scan due to raised CA-125 levels, clinical suspicion of ovarian cancer recurrence, or alterations detected on CT.18 F-FDG PET/CT findings for the women were compared with the final diagnosis.

Results: CA-125 was elevated in 13 patients, while 34 patients presented with alterations on CT, and 9 patients presented with both results’ positivity. 17 patients confirmed to have an ovarian cancer recurrence, all with abnormal findings on PET/ CT. 20 patients remained disease-free during follow-up, all with normal PET/CT findings. There were 9 patients with raised CA-125 levels and normal conventional imaging, all with positive18 F-FDG PET/CT. Among the 30 patients with normal CA-125 levels, 9 patients presented with a positive PET/CT scan. Lymph nodes were the most frequent site. Its sensitivity, specificity, positive predictive value, and negative predictive valuewere 94%, 91%, 77%, and 95%, respectively.

Conclusion: 18F-FDG PET/CT is a useful modality for evaluating the cancer recurrence and extent of the disease. Lymph nodes were the most frequent site. However, there was no statistical significance found between CA-125 levels and 18F-FDG PET/CT findings.

Bangladesh Journal of Medical Science Vol.20(2) 2021 p.302-312

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Abstract
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Published
2021-02-01
How to Cite
Nawi, N., Mohamad, I., Khader, M. A., & Shuaib, I. (2021). Diagnostic accuracy of18F-FDG PET/CT in the evaluation of recurrent ovarian cancer. Bangladesh Journal of Medical Science, 20(2), 302-312. https://doi.org/10.3329/bjms.v20i2.51539
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Original Articles