Investigation of 18F-FDG PET/CT Findings and CA-125 Levels in Ovarian Cancer Staging

Abstract

OBJECTIVE This study aims are to investigate the role of 18F labeled fluoro-2-deoxy-D-glucose positron emission computed tomography/computed tomography (18F FDG PET/CT) in the initial staging and recurrence detection of ovarian cancer and to compare it with the cancer antigen-125 (CA-125) value. METHODS A total of 93 patients with a primary ovarian cancer diagnosis (Group 1 n=41) or suspicion of recurrent ovarian cancer (Group 2 n=52) were included in this study from January 2007 to January 2013. RESULTS The ages of the patients were between 15 and 82 years. In cases with PET positive lesions (n=84); Ovar- ian lesion (n=34), infradiaphragmatic lymph node metastasis (n=46), supradiaphragmatic lymph node metastasis (n=14), peritoneal implant (n=67), and distant metastasis (n=14) were detected. Histopatho- logical examination of 4 PET positive ovarian lesions was not compatible with cancer. In 14 cases with low CA-125 value, 18F FDG PET/CT was able to detect primary/recurrent lesions accurately. In the evaluation of primary/recurrent ovarian cancer, 18F FDG PET/CT had 93% sensitivity, 42.8% specific- ity, 89.2% accuracy, whereas CA-125 had 79.1% sensitivity, 42.8% specificity, and 76.3% accuracy. CONCLUSION In conclusion; even in low CA-125 values, 18F FDG PET/CT is a prominent method that can detect especially extra-abdominal distant metastatic foci in the initial staging of primary ovarian cancer and diagnosis and follow-up of recurrent ovarian cancer.