Peritoneal Carcinomatosis in Primary Ovarian Cancer Staging: Comparison Between MDCT, MRI, and 18F-FDG PET/CT. (May 2015)

• Record Type: Journal Article
• Authors: Schmidt, Sabine; Meuli, Reto Antoine; Achtari, Chahin; Prior, John Olivier
• Is Part Of: Clinical nuclear medicine. Volume 40:Number 5(2015)
• Publication Date: 2015-05
• Subjects: ovarian cancer -- peritoneal carcinomatosis -- MRI -- MDCT -- 18F-FDG PET/CT; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000000768
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: The aim of this study was to compare multidetector CT (MDCT), MRI, and FDG PET/CT imaging for the detection of peritoneal carcinomatosis (PC) in ovarian cancer. Patients and Methods: Fifteen women with ovarian cancer and suspected PC underwent MDCT, MRI, and FDG PET/CT, shortly before surgery. Nine abdominopelvic regions were defined according to the peritoneal cancer index. We applied lesion size scores on MDCT and MR and measured FDG PET/CT standard uptake. We blindly read MDCT, MR, and PET/CT before joint review and comparison with histopathology. Receiver operating characteristics analysis was performed. Results: Ten women had PC (67%). Altogether, 135 abdominopelvic sites were compared. Multidetector CT, MRI, and FDG PET/CT had a sensitivity of 96%, 98%, and 95%, and specificity was 92%, 84%, and 96%, respectively. Corresponding receiver operating characteristics area was 0.94, 0.90, and 0.96, respectively, without any significant differences between them ( P = 0.12). FDG PET/CT detected supradiaphragmatic disease in 3 women (20%) not seen by MDCT or MRI. Conclusions: Although MRI had the highest sensitivity and FDG PET/CT had the highest specificity, no significant differences were found between the 3 techniques. Thus, MDCT, as the fastest, most economical, and most widely available modality, is the examination of choice, if a stand-alone technique is required. If inconclusive, PET/CT or MRI may offer additional insights. Whole-body FDG PET/CT may be more accurate for supradiaphragmatic metastatic extension.