Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France.
CNRS UMR 6299, Centre Régional de Recherche en Cancérologie Nantes-Angers (CRCNA), INSERM U892 , Nantes , France ; Nuclear Medicine, University Hospital Nantes , Nantes , France.
Front Med (Lausanne). 2015 Jul 22;2:46. doi: 10.3389/fmed.2015.00046. eCollection 2015.
The aim of this retrospective study was to evaluate the contribution of fluorine-18-fluoro-deoxyglucose (FDG) positron emission tomography (PET) to the clinical management and survival outcome of patients (pts) suspected of recurrent ovarian carcinoma, with the hypothesis that early diagnosis of recurrent ovarian cancer may improve overall survival (OS).
Fifty-three FDG PET/CT scans were retrospectively analyzed for 42 pts. CT and PET/CT findings were confirmed by imaging and clinical follow-up, and/or pathology, which were considered as the gold standard diagnosis. The treatment plan based on CT staging was compared with that based on PET/CT findings. Medical records were reviewed for pts characteristics, progression-free survival (PFS), and OS. PFS and OS were analyzed using the Cox proportional hazards regression model.
The final diagnosis of recurrence was established pathologically (n = 16), or by a median clinical follow-up of 6.5 years (range 0.5-7.5) after the PET/CT (n = 37). PET/CT provided a higher detection sensitivity (92.2%, 47/51) than CT (60.8%, 31/51) (p < 0.001). Globally, PET/CT modified the treatment plan in 56.6% (30/53) and in 65.2% (15/23) when the CT was negative prior to PET/CT. In 30 cases, those benefited from a modified treatment plan, these changes led to the intensification of a previous treatment procedure in 83.3% (25/30), and to a reduction in the previous treatment procedure in 16.6% of cases (5/30). The Cox regression multivariate analysis showed that the number of lesions visualized by CT and presence of lung lesions detected by PET/CT were significantly associated with PFS (p = 0.002 and p = 0.035, respectively).
On account of its impact on treatment planning, and especially in predicting patient outcome, FDG PET is a valuable diagnostic tool for cases of suspected ovarian cancer recurrence.
本回顾性研究的目的是评估氟-18-氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在疑似复发性卵巢癌患者的临床管理和生存结果中的作用，假设早期诊断卵巢癌复发可能会改善总生存（OS）。
对 42 例患者的 53 例 FDG PET/CT 扫描进行回顾性分析。CT 和 PET/CT 结果通过影像学和临床随访证实，以及/或病理证实，被认为是金标准诊断。基于 CT 分期的治疗计划与基于 PET/CT 结果的治疗计划进行比较。回顾性分析患者特征、无进展生存期（PFS）和 OS。使用 Cox 比例风险回归模型分析 PFS 和 OS。
最终通过病理（n=16）或 PET/CT 后中位数为 6.5 年（范围 0.5-7.5 年）的临床随访（n=37）确定了复发的诊断。PET/CT 的检测灵敏度（92.2%，47/51）高于 CT（60.8%，31/51）（p<0.001）。总体而言，PET/CT 改变了 53 例中的 56.6%（30/53）和 23 例中 CT 阴性时的 65.2%（15/23）的治疗计划。在 30 例中，从修改后的治疗计划中获益的患者，这些变化导致 83.3%（25/30）的患者强化了之前的治疗方案，16.6%（5/30）的患者减少了之前的治疗方案。Cox 回归多变量分析表明，CT 检测到的病变数量和 PET/CT 检测到的肺部病变与 PFS 显著相关（p=0.002 和 p=0.035）。
由于其对治疗计划的影响，尤其是在预测患者预后方面，FDG PET 是疑似卵巢癌复发的有价值的诊断工具。
