Kwan Hyeong Jo1, Soyoung Kim2, Sang Hyun Hwang3, Yong Hyu Jeong4, Eun Ji Nam5, Won Jun Kang6. 1. Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Republic of Korea. 2. Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea. 4. Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea. 5. Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea. 6. Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemungu, Seoul, 03722, Korea. mdkwj@yuhs.ac.
Abstract
OBJECTIVE: Fertility preservation in women with cancer is important for improving their quality of life. Successful ovarian transposition protects the ovary from radiation and preserves ovarian endocrine function and fertility. With the increasing use of 18F-FDG PET/CT in gynecologic malignancies, the findings of transposed ovaries sometimes vary. This study aimed to characterize the 18F-FDG PET/CT findings of surgically transposed ovaries among a large number of patients with various medical conditions. METHODS: We retrospectively reviewed the medical records, including surgical history, and analyzed the findings of the transposed ovaries of patients who underwent ovarian transposition. Quantitative analysis was performed, and the maximum standardized uptake values (SUVs) were recorded. The Hounsfield unit (HU) and size (measured using the long diameter on the axial image) of the transposed ovary were evaluated. RESULTS: No significant change was found in the SUV of the transposed ovaries in relation to age and time after surgery. In two cases in which metastasis occurred in the transposed ovary, the lesions showed higher SUVs and HUs than did the other non-metastatic transposed ovaries. In several serial follow-up cases, varying 18F-FDG uptake was observed. CONCLUSION: The 18F-FDG uptake pattern of the transposed ovary did not differ from that of the normal ovary. Misinterpretation should be avoided by considering surgical records, presence of surgical clips, and patients' disease state. If there is a high uptake in the transposed ovary, it is necessary to check for soft tissue lesions and differentiate metastasis from the physiologic uptake.
OBJECTIVE: Fertility preservation in women with cancer is important for improving their quality of life. Successful ovarian transposition protects the ovary from radiation and preserves ovarian endocrine function and fertility. With the increasing use of 18F-FDG PET/CT in gynecologic malignancies, the findings of transposed ovaries sometimes vary. This study aimed to characterize the 18F-FDG PET/CT findings of surgically transposed ovaries among a large number of patients with various medical conditions. METHODS: We retrospectively reviewed the medical records, including surgical history, and analyzed the findings of the transposed ovaries of patients who underwent ovarian transposition. Quantitative analysis was performed, and the maximum standardized uptake values (SUVs) were recorded. The Hounsfield unit (HU) and size (measured using the long diameter on the axial image) of the transposed ovary were evaluated. RESULTS: No significant change was found in the SUV of the transposed ovaries in relation to age and time after surgery. In two cases in which metastasis occurred in the transposed ovary, the lesions showed higher SUVs and HUs than did the other non-metastatic transposed ovaries. In several serial follow-up cases, varying 18F-FDG uptake was observed. CONCLUSION: The 18F-FDG uptake pattern of the transposed ovary did not differ from that of the normal ovary. Misinterpretation should be avoided by considering surgical records, presence of surgical clips, and patients' disease state. If there is a high uptake in the transposed ovary, it is necessary to check for soft tissue lesions and differentiate metastasis from the physiologic uptake.