The accuracy of PET CT in presurgical local staging of adnexal masses in women suspicious for ovarian cancer

Description

M. Frost¹, V.Prakash¹, V. Iyer¹, R. Fisker², E. Søgaard-Andersen³, K. Nielsen⁴, I. Noer¹;
 1. Nuclear Medicine ; 2. Radiology ; 3. Gynaecology; 4.  Pathology, Aalborg University Hospital, Aalborg, Denmark.

Aim:

The purpose of this study was to investigate the accuracy of 18F-FDG PET/CT-scanning for presurgical local staging of suspected ovarian masses with pathological correlation. Many studies  have demonstrated that visualisation and staging of ovarian cancer can be done by 18F-FDG PET/CT-scanning. Our study compares the 18F-FDG PET/CT-findings in patients with ovarian masses with both intra-operative findings and surgical specimens in 15 patients.

Materials and methods:

 15 prospective patients (mean age 66 years) with adnexal masses suspicious of ovarian cancer and Risk of Malignancy Index > 200 underwent 18F-FDG PET/CT with intravenous contrast before surgery. The PET/CT findings were classified as benign or malignant and were compared with the intra-operative findings and the pathology staging (FIGO criteria). A locally modified PET/CT FIGO classification was also compared with conventional pathological FIGO.

Results:

The preliminary results indicated that PET/CT local staging was correct in 100 percent of patients. There was good correlation between the preoperative18F-FDG PET/CT-report, the intra-operative findings and the histological staging. There was moderate correlation between the modified PET CT and pathological FIGO classification systems.

Conclusions:

18F-FDG PET/CT-scanning can be useful for presurgical local staging of suspected ovarian cancer. Furthermore, as a whole-body examination with intravenous contrast it can give added information about distant metastatic spread and other concomitant pathologies.