A prospective comparison of integrated FDG-PET/contrast-enhanced CT and contrast-enhanced CT for pretreatment imaging of advanced epithelial ovarian cancer
| Autor: | Sinikka Oksa, Olli Carpén, Maija Lavonius, Johanna Virtanen, Annika Auranen, Seija Grénman, Marko Seppänen, Johanna Hynninen, Jaakko Matomäki, Jukka Kemppainen |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Abdominal cavity Carcinoma Ovarian Epithelial Multimodal Imaging Peritoneal cavity Fluorodeoxyglucose F18 medicine Humans Neoplasms Glandular and Epithelial Prospective Studies Radical surgery Aged Neoplasm Staging Ovarian Neoplasms ta3126 PET-CT medicine.diagnostic_test business.industry Obstetrics and Gynecology Middle Aged medicine.disease Debulking ta3122 ta3123 Tumor Debulking medicine.anatomical_structure Oncology Positron emission tomography Positron-Emission Tomography Female Radiology Radiopharmaceuticals Tomography X-Ray Computed Ovarian cancer business |
| Zdroj: | Gynecologic Oncology. 131(2):389-394 |
| ISSN: | 0090-8258 |
| Popis: | Objective The use of tumor debulking surgery in the management of epithelial ovarian cancer (EOC), which is often disseminated in the peritoneal cavity at the time of diagnosis, has a significant impact on prognosis. We compared 18 F-fluorodeoxyglucose (FDG) positron emission tomography/contrast-enhanced computed tomography (PET/CT) to contrast-enhanced CT for the detection of dissemination into the abdominal cavity preventing successful primary debulking surgery. Methods Forty-one women with EOC underwent preoperative whole-body low-dose FDG-PET/CT followed by diagnostic high dose contrast-enhanced CT scan, and the results were compared with systematically recorded surgical findings as a reference standard. Both site-based and patient-based analyses were conducted. Results FDG-PET/CT was superior to conventional CT for the detection of carcinomatosis in subdiaphragmatic peritoneal surfaces ( p =0.020) and in the bowel mesentery ( p =0.001). Patient-based analysis of upper abdominal areas requiring extensive surgical procedures showed no significant differences between the two imaging methods. The sensitivity of PET/CT and CT was poor in certain areas of the peritoneal cavity (64% vs. 27% in the small bowel mesentery and 65% vs. 55% in the right upper abdomen). Extra-abdominal disease spread was detected by PET/CT in 32 patients and by CT in 25 patients. Conclusions PET/CT was not superior to CT for the detection of intra-abdominal disease spread. Patients with suspected EOC should be referred for upfront radical surgery regardless of the results of preoperative imaging studies. PET/CT is more effective for the detection of extra-abdominal disease than CT, but the clinical significance of this finding is unclear. |
| Databáze: | OpenAIRE |
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