Kim Chulhan, Chung Hyun Hoon, Oh So Won, Kang Keon Wook, Chung June-Key, Lee Dong Soo
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea ; Department of Nuclear Medicine, Korea University Ansan Hospital, Ansan, Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Nucl Med Mol Imaging. 2013 Jun;47(2):81-8. doi: 10.1007/s13139-013-0197-5. Epub 2013 Apr 4.
Borderline ovarian tumors (BOTs) are more common in young women of reproductive age, and exhibit a better prognosis than malignant ovarian tumors (MOTs). Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were compared in their ability to differentiate BOTs from stage I MOTs.
Among 173 patients who had preoperative FDG PET/CT due to ovarian neoplasms between November 2006 and March 2009, there were 13 patients with BOTs or stage I MOTs. For differential diagnosis of the two tumors, cancer antigen-125 (CA-125) level, the longest diameter of tumors, metabolic indices including maximum standardized uptake value (SUVmax), and volumetric indices including metabolic tumor volume (MTV) were compared, respectively.
The BOT group (n = 7) was comprised of five mucinous and two serous tumors, and the MOT group (n = 6) was comprised of three endometrioid, two clear cell and one mucinous tumors. Among the comparisons between two groups, SUVmax of the BOT group was significantly lower than that of the MOT group (2.9 ± 1.5 vs. 6.6 ± 2.9, p = 0.0223); otherwise, no significant difference was found in age, CA-125, diameter, or MTV. By receiver-operating characteristic curve analysis, SUVmax of 3.7 was the best cutoff value to differentiate BOTs from stage I MOTs, with a sensitivity of 83.3 % and specificity of 85.7, and the area under curve of 0.893 (p = 0.0001, 95 % CI: 0.601∼0.993).
We demonstrated that SUVmax could distinguish BOTs from stage I MOTs, with a high sensitivity and specificity. Metabolic indices determined by FDG PET/CT were more suitable than volumetric indices for differential diagnosis of the two tumors.
交界性卵巢肿瘤（BOTs）在育龄年轻女性中更为常见，且预后较恶性卵巢肿瘤（MOTs）更好。比较氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）区分BOTs与Ⅰ期MOTs的能力。
在2006年11月至2009年3月期间因卵巢肿瘤进行术前FDG PET/CT检查的173例患者中，有13例患有BOTs或Ⅰ期MOTs。为鉴别这两种肿瘤，分别比较癌抗原125（CA-125）水平、肿瘤最长径、包括最大标准化摄取值（SUVmax）在内的代谢指标以及包括代谢肿瘤体积（MTV）在内的容积指标。
BOT组（n = 7）包括5例黏液性肿瘤和2例浆液性肿瘤，MOT组（n = 6）包括3例子宫内膜样肿瘤、2例透明细胞肿瘤和1例黏液性肿瘤。在两组比较中，BOT组的SUVmax显著低于MOT组（2.9±1.5 vs. 6.6±2.9，p = 0.0223）；否则，在年龄、CA-125、直径或MTV方面未发现显著差异。通过受试者操作特征曲线分析，SUVmax为3.7是区分BOTs与Ⅰ期MOTs的最佳截断值，灵敏度为83.3%，特异性为85.7%，曲线下面积为0.893（p = 0.0001，95%CI：0.601∼0.993）。
我们证明SUVmax能够以高灵敏度和特异性区分BOTs与Ⅰ期MOTs。FDG PET/CT测定的代谢指标比容积指标更适合这两种肿瘤的鉴别诊断。
