Performance of integrated FDG–PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG–PET/non-contrast-enhanced CT and enhanced CT

Purpose The aim of this study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18 F-fluorodeoxyglucose with IV contrast for depiction of suspected recurrent ovarian cancer and to assess the impact of PET/contrast-enhanced CT findings on c...

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Veröffentlicht in:European Journal of Nuclear Medicine 2008-08, Vol.35 (8), p.1439-1448
Hauptverfasser: Kitajima, Kazuhiro, Murakami, Koji, Yamasaki, Erena, Domeki, Yasushi, Kaji, Yasushi, Fukasawa, Ichio, Inaba, Noriyuki, Suganuma, Narufumi, Sugimura, Kazuro
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container_end_page 1448
container_issue 8
container_start_page 1439
container_title European Journal of Nuclear Medicine
container_volume 35
creator Kitajima, Kazuhiro
Murakami, Koji
Yamasaki, Erena
Domeki, Yasushi
Kaji, Yasushi
Fukasawa, Ichio
Inaba, Noriyuki
Suganuma, Narufumi
Sugimura, Kazuro
description Purpose The aim of this study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18 F-fluorodeoxyglucose with IV contrast for depiction of suspected recurrent ovarian cancer and to assess the impact of PET/contrast-enhanced CT findings on clinical management, compared with PET/non-contrast-enhanced CT and CT component. Methods One hundred thirty-two women previously treated for ovarian cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast enhanced CT, PET/non-contrast-enhanced CT, and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging, and clinical follow-up for longer than 6 months. Results Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/contrast-enhanced CT were 78.8% (52 of 66), 90.9% (60 of 66), and 84.8% (112 of 132), respectively, whereas those of PET/non-contrast-enhanced CT were 74.2% (49 of 66), 90.9% (60 of 66), and 82.6% (109 of 132), respectively, and those of enhanced CT were 60.6% (40 of 66), 84.8% (56 of 66), and 72.7% (96 of 132), respectively. Sensitivity, specificity, and accuracy differed significantly among the three modalities (Cochran Q test: p  = 0.0001, p  = 0.018, and p  
doi_str_mv 10.1007/s00259-008-0776-3
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Methods One hundred thirty-two women previously treated for ovarian cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast enhanced CT, PET/non-contrast-enhanced CT, and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging, and clinical follow-up for longer than 6 months. Results Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/contrast-enhanced CT were 78.8% (52 of 66), 90.9% (60 of 66), and 84.8% (112 of 132), respectively, whereas those of PET/non-contrast-enhanced CT were 74.2% (49 of 66), 90.9% (60 of 66), and 82.6% (109 of 132), respectively, and those of enhanced CT were 60.6% (40 of 66), 84.8% (56 of 66), and 72.7% (96 of 132), respectively. Sensitivity, specificity, and accuracy differed significantly among the three modalities (Cochran Q test: p  = 0.0001, p  = 0.018, and p  &lt; 0.0001, respectively). The findings of PET/contrast-enhanced CT resulted in a change of management for 51 of the 132 patients (39%) and had an effect on patient management in 16 patients (12%) diagnosed by enhanced CT alone and three patients (2%) diagnosed by PET/non-contrast-enhanced CT. Conclusion Integrated PET/contrast-enhanced CT is an accurate modality for assessing ovarian cancer recurrence and led to changes in the subsequent appropriate therapy.</description><identifier>ISSN: 1619-7070</identifier><identifier>ISSN: 0340-6997</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-008-0776-3</identifier><identifier>PMID: 18418592</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Cardiology ; Comparative studies ; Contrast Media ; Female ; Fluorodeoxyglucose F18 ; Humans ; Imaging ; Integrated approach ; Iopamidol - analogs &amp; derivatives ; Male ; Medical diagnosis ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neoplasm Recurrence, Local - diagnosis ; Nuclear Medicine ; Oncology ; Original Article ; Orthopedics ; Ovarian cancer ; Ovarian Neoplasms - diagnosis ; Positron-Emission Tomography - methods ; Radiology ; Radiopharmaceuticals ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique ; Systems Integration ; Tomography ; Tomography, X-Ray Computed - methods</subject><ispartof>European Journal of Nuclear Medicine, 2008-08, Vol.35 (8), p.1439-1448</ispartof><rights>Springer-Verlag 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-e4fa51b57fe9543d79bd1fa516ac7e030ab797b2d7b11a6759e79e6ac49588a33</citedby><cites>FETCH-LOGICAL-c400t-e4fa51b57fe9543d79bd1fa516ac7e030ab797b2d7b11a6759e79e6ac49588a33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-008-0776-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-008-0776-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18418592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kitajima, Kazuhiro</creatorcontrib><creatorcontrib>Murakami, Koji</creatorcontrib><creatorcontrib>Yamasaki, Erena</creatorcontrib><creatorcontrib>Domeki, Yasushi</creatorcontrib><creatorcontrib>Kaji, Yasushi</creatorcontrib><creatorcontrib>Fukasawa, Ichio</creatorcontrib><creatorcontrib>Inaba, Noriyuki</creatorcontrib><creatorcontrib>Suganuma, Narufumi</creatorcontrib><creatorcontrib>Sugimura, Kazuro</creatorcontrib><title>Performance of integrated FDG–PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG–PET/non-contrast-enhanced CT and enhanced CT</title><title>European Journal of Nuclear Medicine</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose The aim of this study was to evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18 F-fluorodeoxyglucose with IV contrast for depiction of suspected recurrent ovarian cancer and to assess the impact of PET/contrast-enhanced CT findings on clinical management, compared with PET/non-contrast-enhanced CT and CT component. Methods One hundred thirty-two women previously treated for ovarian cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast enhanced CT, PET/non-contrast-enhanced CT, and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging, and clinical follow-up for longer than 6 months. Results Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/contrast-enhanced CT were 78.8% (52 of 66), 90.9% (60 of 66), and 84.8% (112 of 132), respectively, whereas those of PET/non-contrast-enhanced CT were 74.2% (49 of 66), 90.9% (60 of 66), and 82.6% (109 of 132), respectively, and those of enhanced CT were 60.6% (40 of 66), 84.8% (56 of 66), and 72.7% (96 of 132), respectively. Sensitivity, specificity, and accuracy differed significantly among the three modalities (Cochran Q test: p  = 0.0001, p  = 0.018, and p  &lt; 0.0001, respectively). The findings of PET/contrast-enhanced CT resulted in a change of management for 51 of the 132 patients (39%) and had an effect on patient management in 16 patients (12%) diagnosed by enhanced CT alone and three patients (2%) diagnosed by PET/non-contrast-enhanced CT. 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Methods One hundred thirty-two women previously treated for ovarian cancer underwent PET/CT consisting of non-enhanced and contrast-enhanced CT for suspected recurrence. PET/contrast enhanced CT, PET/non-contrast-enhanced CT, and enhanced CT were interpreted by two experienced radiologists by consensus for each investigation. Lesion status was determined on the basis of histopathology, radiological imaging, and clinical follow-up for longer than 6 months. Results Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/contrast-enhanced CT were 78.8% (52 of 66), 90.9% (60 of 66), and 84.8% (112 of 132), respectively, whereas those of PET/non-contrast-enhanced CT were 74.2% (49 of 66), 90.9% (60 of 66), and 82.6% (109 of 132), respectively, and those of enhanced CT were 60.6% (40 of 66), 84.8% (56 of 66), and 72.7% (96 of 132), respectively. Sensitivity, specificity, and accuracy differed significantly among the three modalities (Cochran Q test: p  = 0.0001, p  = 0.018, and p  &lt; 0.0001, respectively). The findings of PET/contrast-enhanced CT resulted in a change of management for 51 of the 132 patients (39%) and had an effect on patient management in 16 patients (12%) diagnosed by enhanced CT alone and three patients (2%) diagnosed by PET/non-contrast-enhanced CT. Conclusion Integrated PET/contrast-enhanced CT is an accurate modality for assessing ovarian cancer recurrence and led to changes in the subsequent appropriate therapy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>18418592</pmid><doi>10.1007/s00259-008-0776-3</doi><tpages>10</tpages></addata></record>
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0340-6997
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subjects Adult
Aged
Cardiology
Comparative studies
Contrast Media
Female
Fluorodeoxyglucose F18
Humans
Imaging
Integrated approach
Iopamidol - analogs & derivatives
Male
Medical diagnosis
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - diagnosis
Nuclear Medicine
Oncology
Original Article
Orthopedics
Ovarian cancer
Ovarian Neoplasms - diagnosis
Positron-Emission Tomography - methods
Radiology
Radiopharmaceuticals
Reproducibility of Results
Sensitivity and Specificity
Subtraction Technique
Systems Integration
Tomography
Tomography, X-Ray Computed - methods
title Performance of integrated FDG–PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG–PET/non-contrast-enhanced CT and enhanced CT
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