Objective: The aim of this prospective study was to evaluate 18F-FDG-PET, in comparison with CT, for the detection of peritoneal and retroperitoneal metastases of ovarian cancer. Methodology: 13 patients with primary (n = 7) or recurrent (n = 6) ovarian cancer underwent an attenuation-corrected 18F-FDG-PET of the abdomen as well as a contrast-enhanced abdominal CT, followed by surgical staging. For data analysis, the abdomen was artificially divided into six regions (right and left subphrenic region, right and left paracolic gutter, retroperitoneum and central abdomen). All images were reviewed and each region was visually scored on 18F-FDG-PET as well as on CT. 18F-FDG-PET results were compared with those of CT, using the surgical data as gold standard. Results: 73 regions were evaluable surgically and or histologically. Sensitivity was slightly better for CT than for 18F-FDG-PET (74 vs. 66%). Metastases of <5 mm were missed with both techniques. Specificity, however, was clearly better for 18F-FDG-PET than for CT (94 vs. 77%), especially in patients with recurrent disease, where postoperative changes (hematomas, adhesions, etc.) caused more false positive results on CT. Retroperitoneal lymph node involvement was found in 3/13 patients. The result of 18F-FDG-PET for the retroperitoneal lymph nodes was correct in all cases, whereas CT was false positive in 2 patients. 18F-FDG-PET is relatively inaccurate for the right and the left subphrenic region (missing tumor involvement in 5 patients compared to 2 patients for CT). Conclusion: Given the low sensitivity of both 18F-FDG-PET and CT for the detection of peritoneal metastases, surgical staging remains the gold standard. Because of the better specificity, 18F-FDG-PET might be preferred for evaluating residual or recurrent disease after surgery. 18F-FDG-PET was more sensitive in the retroperitoneal region than intraperitoneal.

Keywords:
Positron emission tomography, Fluoro-2-deoxy-D-glucose, Peritoneal metastases, Ovarian cancer
This content is only available via PDF.
© 2003 S. Karger AG, Basel
2003
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.