OBJECTIVE: The use of tumor debulking surgery in the management of epithelial ovarian cancer (EOC), which is often disseminated in the peritoneal cavity at the time of diagnosis, has a significant impact on prognosis. We compared (18)F-fluorodeoxyglucose (FDG) positron emission tomography/contrast-enhanced computed tomography (PET/CT) to contrast-enhanced CT for the detection of dissemination into the abdominal cavity preventing successful primary debulking surgery. METHODS: Forty-one women with EOC underwent preoperative whole-body low-dose FDG-PET/CT followed by diagnostic high dose contrast-enhanced CT scan, and the results were compared with systematically recorded surgical findings as a reference standard. Both site-based and patient-based analyses were conducted. RESULTS: FDG-PET/CT was superior to conventional CT for the detection of carcinomatosis in subdiaphragmatic peritoneal surfaces (p=0.020) and in the bowel mesentery (p=0.001). Patient-based analysis of upper abdominal areas requiring extensive surgical procedures showed no significant differences between the two imaging methods. The sensitivity of PET/CT and CT was poor in certain areas of the peritoneal cavity (64% vs. 27% in the small bowel mesentery and 65% vs. 55% in the right upper abdomen). Extra-abdominal disease spread was detected by PET/CT in 32 patients and by CT in 25 patients. CONCLUSIONS: PET/CT was not superior to CT for the detection of intra-abdominal disease spread. Patients with suspected EOC should be referred for upfront radical surgery regardless of the results of preoperative imaging studies. PET/CT is more effective for the detection of extra-abdominal disease than CT, but the clinical significance of this finding is unclear.
OBJECTIVE: The use of tumor debulking surgery in the management of epithelial ovarian cancer (EOC), which is often disseminated in the peritoneal cavity at the time of diagnosis, has a significant impact on prognosis. We compared (18)F-fluorodeoxyglucose (FDG) positron emission tomography/contrast-enhanced computed tomography (PET/CT) to contrast-enhanced CT for the detection of dissemination into the abdominal cavity preventing successful primary debulking surgery. METHODS: Forty-one women with EOC underwent preoperative whole-body low-dose FDG-PET/CT followed by diagnostic high dose contrast-enhanced CT scan, and the results were compared with systematically recorded surgical findings as a reference standard. Both site-based and patient-based analyses were conducted. RESULTS:FDG-PET/CT was superior to conventional CT for the detection of carcinomatosis in subdiaphragmatic peritoneal surfaces (p=0.020) and in the bowel mesentery (p=0.001). Patient-based analysis of upper abdominal areas requiring extensive surgical procedures showed no significant differences between the two imaging methods. The sensitivity of PET/CT and CT was poor in certain areas of the peritoneal cavity (64% vs. 27% in the small bowel mesentery and 65% vs. 55% in the right upper abdomen). Extra-abdominal disease spread was detected by PET/CT in 32 patients and by CT in 25 patients. CONCLUSIONS: PET/CT was not superior to CT for the detection of intra-abdominal disease spread. Patients with suspected EOC should be referred for upfront radical surgery regardless of the results of preoperative imaging studies. PET/CT is more effective for the detection of extra-abdominal disease than CT, but the clinical significance of this finding is unclear.
Authors: Jeong Won Lee; Arthur Cho; Jae-Hoon Lee; Mijin Yun; Jong Doo Lee; Young Tae Kim; Won Jun Kang Journal: Eur J Nucl Med Mol Imaging Date: 2014-05-23 Impact factor: 9.236
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Authors: Alexi A Wright; Kari Bohlke; Deborah K Armstrong; Michael A Bookman; William A Cliby; Robert L Coleman; Don S Dizon; Joseph J Kash; Larissa A Meyer; Kathleen N Moore; Alexander B Olawaiye; Jessica Oldham; Ritu Salani; Dee Sparacio; William P Tew; Ignace Vergote; Mitchell I Edelson Journal: Gynecol Oncol Date: 2016-08-08 Impact factor: 5.482
Authors: Alexi A Wright; Kari Bohlke; Deborah K Armstrong; Michael A Bookman; William A Cliby; Robert L Coleman; Don S Dizon; Joseph J Kash; Larissa A Meyer; Kathleen N Moore; Alexander B Olawaiye; Jessica Oldham; Ritu Salani; Dee Sparacio; William P Tew; Ignace Vergote; Mitchell I Edelson Journal: J Clin Oncol Date: 2016-08-08 Impact factor: 44.544
Authors: Jean M Hansen; Anil K Sood; Robert L Coleman; Shannon N Westin; Pamela T Soliman; Pedro T Ramirez; Bryan M Fellman; Kathleen M Schmeler; Nicole D Fleming Journal: Gynecol Oncol Date: 2018-10-23 Impact factor: 5.482