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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Role of 18F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging ...
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Vol. 33. Issue 1.
Pages 22-27 (January - February 2014)
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Vol. 33. Issue 1.
Pages 22-27 (January - February 2014)
Original article
Role of 18F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125
Papel del 18F-FDG PET/CT en el diagnóstico de carcinomatosis peritoneal en la reclasificación de los pacientes con cáncer de ovario en comparación con el TC con contraste y con el marcador tumoral Ca-125
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G. Rubinia, C. Altinia, A. Notaristefanoa, N. Merendaa, D. Rubinia, A.A. Stabile Ianorab, A. Niccoli Asabellaa,
Corresponding author
artor.niccoliasabella@uniba.it

Corresponding author.
a D.I.M. – Diagnostic Imaging – Nuclear Medicine, University of Bari “Aldo Moro”, Bari, Italy
b D.I.M. – Radiodiagnostic Unit, University of Bari “Aldo Moro”, Italy
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Tables (5)
Table 1. Patients’ clinical characteristics, histology, surgical and 18F-FDG PET/CT findings.
Table 2. 18F-FDG PET/CT statistical results for identifying peritoneal carcinomatosis in 79 patients.
Table 3. 18F-FDG PET/CT scan findings in all patients.
Table 4. Sensitivity, specificity, accuracy, PPV and NPV for detecting peritoneal carcinomatosis in group A.
Table 5. Sensitivity and specificity, accuracy, PPV and NPV for detecting peritoneal carcinomatosis in group B.
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Abstract
Objectives

To investigate the role of whole-body fluorine-18-2-deoxy-2-fluoro-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the identification of peritoneal carcinomatosis in patients with ovarian cancer (OC).

Material and methods

Seventy-nine patients with histologically proven stages III–IV OC who underwent 18F-FDG PET/CT were studied retrospectively. We considered group A as 51 patients who also underwent computed-tomography with contrast-enhancement (CECT), and group B as 35 patients who had also been tested for biomarker Ca-125. Sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of 18F-FDG PET/CT as compared to CECT and to Ca-125 were evaluated.

Results

18F-FDG PET/CT’ sensitivity, specificity, accuracy, PPV and NPV for all 79 patients were: 85%, 92.31%, 88.61%, 91.89% and 85.71%, respectively. 18F-FDG PET/CT sensitivity in group A was 78.6%, while it was 53.6% for CECT. 18F-FDG PET/CT specificity, calculated in the same group, was 91.3%, while that of CECT was 60.9% (statistically significant difference, McNemar 4, P=0.039). Accuracy was 84.3% and 56.9%, respectively. 18F-FDG PET/CT’ sensitivity in group B was 86.4%, while that of Ca-125 was 81.8% (no statistical difference, McNemar 0, P=1). 18F-FDG PET/CT specificity in group B was 84.6% while that of Ca-125 was 38.5% (clear but not statistically significant difference, McNemar 3.12, P=0.070). Accuracy calculated in the same group was 85.7% for 18F-FDG PET/CT and 65.7% for Ca-125.

Conclusion

18F-FDG PET/CT is a useful diagnostic tool when peritoneal biopsy cannot be performed and it can better select those who are candidates for adjuvant chemotherapy.

Keywords:
Ovarian cancer
Peritoneal metastases
18F-FDG PET/CT
Contrast enhanced CT
Ca-125
Resumen
Objetivos

Investigar el papel de flúor-18-2-desoxi-2-fluoro-D-glucosa tomografía por emisión de positrones/tomografía computarizada (18F-FDG PET/CT) en la identificación de la carcinomatosis peritoneal en pacientes con cáncer de ovario (CO).

Material y métodos

Setenta y nueva pacientes con CO en estadio III-IV que se sometieron a 18F-FDG PET/CT fueron estudiadas retrospectivamente. Consideramos el grupo A de 51 pacientes que también realizaron la tomografía computarizada con contraste (CECT) y el grupo B de 35 pacientes que tenían cuantificación del Ca-125. Se evaluó sensibilidad, especificidad, exactitud, valor predictivo positivo (VPP) y valores predictivos negativos (VPN) de 18F-FDG PET/CT en comparación con CECT y Ca-125.

Resultados

La sensibilidad, especificidad, exactitud, VPP y VPN de 18F-FDG PET/CT en los 79 pacientes fueron: 85, 92,31, 88,61, 91,89 y 85,71% respectivamente. La sensibilidad de 18F-FDG PET/CT en el grupo A fue de 78,6% y de 53,6% por CECT. La especificidad de 18F-FDG PET/CT en el mismo grupo fue de 91,3%, mientras la de CECT del 60,9% (diferencia estadísticamente significativa, McNemar=4, P=0,039); la exactitud fue respectivamente de 84,3 y 56,9%. La sensibilidad de la 18F-FDG PET/CT en el grupo B fue de 86,4%, mientras que la del Ca-125 fue de 81,8% (sin diferencia estadística, McNemar=0, P=1). La especificidad 18F-FDG PET/CT en el grupo B fue de 84,6%, mientras que la del Ca-125 fue de 38,5% (diferencia evidente, no estadísticamente significativa, McNemar=3,12, P=0,070). La exactitud en el mismo grupo fue 85,7% para el 18F-FDG PET/CT y 65,7% para Ca-125.

Conclusión

La 18F-FDG PET/CT es un instrumento de diagnóstico útil cuando la biopsia peritoneal no se puede realizar y puede seleccionar de manera mejor las candidatas a quimioterapia adyuvante.

Palabras clave:
Cáncer de ovario
Metástasis peritoneales
18F-FDG PET/CT
CT contraste
Ca-125

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