Diagnostic accuracy of PET/CT scan in evaluation of clinically suspected recurrent ovarian cancer

N. Sultana, S. Shoukat, Sadaf Nausheen, Bakhtawar Memon
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Abstract

Background: Accurate evaluation of ovarian carcinoma is utmost important for effective management. PET/CT is reported to be effective in evaluation of suspected recurrence of ovarian carcinoma. This study aims to assess the accuracy of PET/CT in evaluation of recurrent ovarian cancer among clinically suspected cases with rising tumor marker or suspicious clinic-radiological findings. Patients and methods: This prospective cross-sectional study was conducted at Radiology department of Jinnah Postgraduate Medical Centre Karachi from 22nd April 2019 to 21st April 2020. Patients having age of 40 to 60 years and referred for PET scan with suspected recurrence of ovarian carcinoma were consecutively enrolled. Patients were suspected due to relevant history, clinical findings and initial imaging investigations with elevated CA-125 level. Results of 18FDG PET/CT scan was correlated with the raised tumor findings. The PET/CT scan showing abnormally elevated FDG take-up and higher SUV values than the background activity considered recurrence. Diagnostic accuracy of PET/CT was calculated taking raised tumor level as reference category. Results: Of 65 patients, median age was 50 (43-56) years. The findings showed positive cases in 57 (87.7%) while negative in 8 (12.3%) patients, whereas the findings of tumor marker showed raised tumor marker in 61 (93.8%) patients. Diagnostic accuracy of PET/CT showed sensitivity, specificity, positive predicted value, negative predated value, and overall diagnostic accuracy as 93.44%, 100%, 100%, 50%, and 93.85% respectively. Conclusion: A higher accuracy of PET/CT was observed in the diagnosis of recurrent ovarian cancer among clinically suspected cases, thus helping in devising an appropriate management plan by the treating physician.
PET/CT对临床疑似复发性卵巢癌的诊断准确性评价
背景:准确评估卵巢癌对有效治疗至关重要。据报道,PET/CT对卵巢癌疑似复发的评估是有效的。本研究旨在评估PET/CT对临床疑似肿瘤标志物升高或临床影像学表现可疑的复发性卵巢癌的评估准确性。患者和方法:这项前瞻性横断面研究于2019年4月22日至2020年4月21日在卡拉奇真纳研究生医学中心放射科进行。年龄在40 ~ 60岁之间,疑似卵巢癌复发而行PET扫描的患者连续入选。由于相关病史、临床表现和初步影像学检查,患者被怀疑CA-125水平升高。18FDG PET/CT扫描结果与升高的肿瘤表现相关。PET/CT扫描显示异常升高的FDG摄取和高于背景活动的SUV值考虑复发。以升高的肿瘤水平作为参考分类,计算PET/CT的诊断准确率。结果:65例患者中位年龄为50(43-56)岁。结果阳性57例(87.7%),阴性8例(12.3%),肿瘤标志物升高61例(93.8%)。PET/CT的诊断准确率敏感性为93.44%,特异性为100%,阳性预测值为100%,阴性预测值为100%,总体诊断准确率为50%,93.85%。结论:PET/CT对临床疑似复发性卵巢癌的诊断具有较高的准确性,有助于主治医师制定合理的治疗方案。
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