Aims: To (a) assess the accuracy of 18F-FDG PET/CT in distinguishing malignant from benign pelvic lesions, compared to transvaginal ultrasonography (TVUS) and (b) to establish the role of whole-body 18F-FDG PET/CT, compared to contrast enhanced computed tomography (CT), in staging patients with ovarian cancer.
Patients: Fifty consecutive patients with a pelvic lesion, already scheduled for surgery on the basis of physical examination, TVUS, and serum Ca125 levels, were enrolled in the study. Patients' age ranged between 23 and 89 years (mean 64). All patients underwent TVUS including a colour Doppler study followed by a thorax and abdominal CT scan, and whole-body 18F-FDG PET/CT within 2 weeks prior to surgery. Histological findings obtained at surgery were taken as the 'gold standard' to compare 18F-FDG PET/CT and TVUS, and 18F-FDG PET/CT vs. CT. When tissue analysis showed ovarian cancer, the accuracy of 18F-FDG PET/CT and CT were compared for the purpose of obtaining a precise staging.
Results: At surgery, the ovarian lesions were malignant in 32/50 patients (64%) and benign in the remaining 18/50 patients (36%). The sensitivity, specificity, NPV, PPV and accuracy of 18F-FDG PET/CT were 87%, 100%, 81%, 100% and 92%, respectively, compared with 90%, 61%, 78%, 80% and 80%, respectively, for TVUS. In staging ovarian cancer, 18F-FDG PET/CT results were concordant with final pathological staging in 22/32 (69%) patients while CT results were concordant in 17/32 (53%) patients. CT incorrectly down-staged four out of six stage IV patients by missing distant metastasis in the liver, pleura, mediastinum, and in left supraclavicular lymph nodes, which were correctly detected by 18F-FDG PET/CT.
Conclusion: PET/CT with 18F-FDG provides additional value to TVUS for the differential diagnosis of benign from malignant pelvic lesions, and to CT for the staging of ovarian cancer patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/MNM.0b013e3281afa256 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[18F]Tetrafluoroborate: a new NIS PET/CT radiopharmaceutical. An overview focused on differentiated thyroid cancer.
Eur Thyroid J
January 2025
G Treglia, Repubblica e Cantone Ticino Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Background: In relapsing differentiated thyroid cancer (DTC), the in vivo evaluation of natrium-iodine symporter (NIS) expression is pivotal in the therapeutic planning and is achieved by [131/123I]Iodine whole-body scan. However, these approaches have low sensitivity due to the low sensitivity due to the low resolution of SPECT. [18F]Tetrafluoroborate (TFB) has been proposed as a viable alternative, which could outperform [131/123I]Iodine scans owing to the superior PET resolution.
View Article and Find Full Text PDFRare Primary Pericardial Mesothelioma on an [18F]FDG PET/CT Scan and Its Postchemotherapy Response Evaluation.
Indian J Nucl Med
November 2024
Department of Nuclear Medicine and PET CT, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
Primary pericardial mesothelioma is a highly aggressive and rare neoplasm that arises from the pericardial mesothelial cell and has a poor prognosis. The diagnosis is usually established by histological and immunohistochemical studies. Malignant mesothelioma most frequently occurs from the pleura (90%), less frequently from the peritoneum and pericardium (6%-10%), and very rarely from the tunica vaginalis in the testis.
View Article and Find Full Text PDFAtypical Presentation of Carcinoma Breast as Paraneoplastic Cerebellar Degeneration on [18F]FDG PET/CT.
Indian J Nucl Med
November 2024
Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Paraneoplastic neurological syndrome (PNS) represents a rare group of central nervous system disorders that are unrelated to direct tumor invasion or metastasis but may be triggered by an immune system reaction to a neoplasm or malignant tumor. In many patients, PNS is diagnosed before identifying the primary cancer. In such instances, positron emission tomography/computed tomography scan can assess individuals with suspected PNS enabling the detection of hidden malignancies.
View Article and Find Full Text PDFOptimizing Low-Dose [18F]FDG-PET/CT Scans: Ensuring Quality Amid Radiotracer Availability Challenges - Insights from a Peripheral Tertiary Care Center.
Indian J Nucl Med
November 2024
Department of Nuclear Medicine and Molecular Imaging, Homi Bhabha Cancer Hospital & Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Varanasi, India.
Background: The introduction of positron emission tomography/computed tomography (PET/CT) has significantly advanced medical imaging. In oncology, F-fluorodeoxyglucose (F-FDG) PET/CT is particularly crucial for staging, evaluating treatment response, monitoring follow-up, and planning radiotherapy. However, in resource limiting hospitals, the availability of fluorine-labeled F-FDG limits optimal scan acquisition.
View Article and Find Full Text PDF[18F]FDG PET/CT in Necrotizing Fasciitis: A Case Series Investigating the Clinical Utility in a Challenging and Rare Condition.
Indian J Nucl Med
November 2024
Radiation Medicine Centre, Bhabha Atomic Research Centre, TMC Annexe, Mumbai, Maharashtra, India.
Necrotizing fasciitis is a deadly yet rare soft tissue and skin infection that is usually diagnosed clinically. At times, clinical signs may betray the underlying etiology and masquerade as cellulitis in the early course of the disease. We report four cases with clinical suspicion of necrotizing fasciitis, some after the failure of therapy for cellulitis who underwent 18-F fluorodeoxyglucose positron emission tomography-computed tomography (18-F FDG PET/CT) showing the extent of the disease, showing subclinical sites of involvement in patients with necrotizing fasciitis on baseline scan as well as its role in assessing response to treatment using 18-F FDG PET/CT.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!