Eur Radiol 2000;10(5):761-7
Value of (18F)-FDG positron emission tomography, computed tomography, and
magnetic resonance imaging in diagnosing primary and recurrent ovarian
carcinoma.
Kubik-Huch RA, Dorffler W, von Schulthess GK, Marincek B, Kochli OR, Seifert B,
Haller U, Steinert HC.
The aim of this study was to compare prospectively the accuracy of whole-body
positron emission tomography (PET), CT and MRI in diagnosing primary and
recurrent ovarian cancer. Nineteen patients (age range 23-76 years) were
recruited with suspicious ovarian lesions at presentation (n = 8) or follow-up
for recurrence (n = 11). All patients were scheduled for laparotomy and
histological confirmation. Whole-body PET with FDG, contrast-enhanced spiral CT
of the abdomen, including the pelvis, and MRI of the entire abdomen were
performed. Each imaging study was evaluated separately. Imaging findings were
correlated with histopathological diagnosis. The sensitivity, specificity and
accuracy for lesion characterization in patients with suspicious ovarian lesions
(n = 7) were, respectively: 100, 67 and 86% for PET; 100, 67 and 86% for CT; and
100, 100 and 100% for MRI. For the diagnosis of recurrent disease (n = 10), PET
had a sensitivity of 100%, specificity of 50% and accuracy of 90%. The PET
technique was the only technique which correctly identified a single transverse
colon metastasis. Results for CT were 40, 50 and 43%, and for MRI 86, 100 and
89%, respectively. No statistically significant difference was seen. Neither FDG
PET nor CT nor MRI can replace surgery in the detection of microscopic
peritoneal disease. No statistically significant difference was observed for the
investigated imaging modalities with regard to lesion characterization or
detection of recurrent disease; thus, the methods are permissible alternatives.
The PET technique, however, has the drawback of less accurate spatial assignment
of small lesions compared with CT and MRI.
