Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Int J Gynecol Cancer. 2010 Aug;20(6):936-44. doi: 10.1111/IGC.0b013e3181e82a7f.
This study was conducted to estimate the accuracy of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) as compared with contrast-enhanced CT (CECT) in detecting cancer in patients who have normal cancer antigen (CA)-125 (<35 U/dL) but are suspected of having a recurrent disease based on clinical symptoms.
We retrospectively reviewed the records of patients who had undergone primary cytoreductive surgery and subsequently underwent CECT and FDG-PET/CT for suspected recurrence. [18F]-fluorodeoxyglucose positron emission tomography/computed tomography and CECT interpretation to evaluate a recurrent disease was carried out independently by 2 experienced radiologists who were blinded to the final diagnosis for the suspected recurrence. Long-term follow-up imaging (12 months) and biopsy reports were used to assess the true status of the suspected recurrence seen on FDG-PET/CT or CECT. Sensitivity and specificity of all modalities were estimated. McNemar test was used to compare pairs of modalities. All tests were 2-sided, and P < or = 0.05 was considered statistically significant.
Sixty-six patients met the eligibility criteria for inclusion in our analysis. Fifty-eight percent (18/31) and 54% (17/31) of the patients with normal CA-125 levels had evidence of a recurrent disease on FDG-PET/CT and CECT, respectively. Thirty-one percent (6/19) of the patients with no indication of cancer on CECT had evidence of disease on FDG-PET/CT images, which was supported by pathological proof.
[18F]-Fluorodeoxyglucose positron emission tomography/computed tomography is capable of detecting ovarian cancer recurrence in symptomatic patients with normal CA-125 levels and, in this setting, has slightly better sensitivity than CECT and can be considered as the frontline modality for all such patients.
本研究旨在评估氟[18F]-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）与增强对比计算机断层扫描（CECT）相比，在检测 CA-125（<35 U/dL）正常但基于临床症状怀疑疾病复发的患者中的准确性。
我们回顾性分析了接受过初次细胞减灭术，随后因疑似复发而行 CECT 和 FDG-PET/CT 检查的患者的病历。FDG-PET/CT 和 CECT 由 2 位经验丰富的放射科医生独立进行解读，他们对疑似复发的最终诊断并不知情。长期随访的影像学（12 个月）和活检报告用于评估 FDG-PET/CT 或 CECT 上疑似复发的真实情况。估计所有检查的敏感性和特异性。采用 McNemar 检验比较两种检查方式。所有检验均为双侧检验，P<0.05 认为具有统计学意义。
共有 66 例患者符合纳入本分析的标准。CA-125 水平正常的患者中，58%（18/31）和 54%（17/31）在 FDG-PET/CT 和 CECT 上有复发的证据。在 CECT 上无癌症迹象的 19 例患者中有 31%（6/19）在 FDG-PET/CT 图像上有疾病证据，这得到了病理证明的支持。
在 CA-125 水平正常且有症状的患者中，FDG-PET/CT 能够检测卵巢癌的复发，在这种情况下，其敏感性略优于 CECT，可以被视为所有此类患者的一线检查方式。
