University Hospital Aachen, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen, Germany.
University Hospital Aachen, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen, Germany; Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
Eur J Radiol. 2014 Mar;83(3):463-7. doi: 10.1016/j.ejrad.2013.12.006. Epub 2013 Dec 12.
The aim of the present study was to investigate the diagnostic and prognostic value of combined (18)F-2-fluorodeoxyglucose positron emission tomography and contrast enhanced X-ray computed tomography (FDG-PET/CT) in women with a suspicion of recurrent ovarian cancer.
We retrospectively reviewed 48 patients with a suspicion of recurrent ovarian cancer who were referred to our department for combined FDG-PET/CT.
Median follow-up was 25 months. 38/48 (79%) patients showed pathological findings on PET/CT. 17/48 (35%) of patients died of ovarian cancer. One FDG-PET/CT was false positive and one was false negative, leading to a sensitivity and positive predictive value of 97% and a specificity and negative predictive value of 90%. 33/48 (69%) underwent a change in therapy following FDG-PET/CT. There was a significantly better survival in FDG-PET/CT negative than in positive patients (p=0.04). In the FDG-PET/CT negative group no patients had died of ovarian cancer during follow-up. Remarkably, there was no difference in survival between patients who only had peritoneal metastases on FDG-PET/CT and those who also had extraperitoneal metastases (p=0.71).
A negative FDG-PET/CT has a high negative predictive value for the presence of disease and, more importantly, is associated with a very good disease-specific survival rate.
本研究旨在探讨(18)F-2-氟脱氧葡萄糖正电子发射断层扫描和对比增强 X 射线计算机断层扫描(FDG-PET/CT)联合应用于疑似复发性卵巢癌女性的诊断和预后价值。
我们回顾性分析了 48 例疑似复发性卵巢癌患者,这些患者因疑似复发性卵巢癌而被转诊至我院进行 FDG-PET/CT 联合检查。
中位随访时间为 25 个月。在 48 例患者中,38 例(79%)患者在 PET/CT 上有病理学发现。48 例患者中有 17 例(35%)死于卵巢癌。1 例 FDG-PET/CT 假阳性,1 例假阴性,灵敏度和阳性预测值为 97%,特异性和阴性预测值为 90%。48 例患者中有 33 例(69%)在 FDG-PET/CT 后进行了治疗改变。FDG-PET/CT 阴性患者的生存率明显优于阳性患者(p=0.04)。在 FDG-PET/CT 阴性组中,没有患者在随访期间死于卵巢癌。值得注意的是,在 FDG-PET/CT 上仅发现腹膜转移和同时存在腹膜外转移的患者之间,生存率没有差异(p=0.71)。
FDG-PET/CT 阴性对疾病的存在具有很高的阴性预测价值,更重要的是,与非常好的疾病特异性生存率相关。