ATL. Issue 3 (1st March 2014)

• Record Type: Journal Article
• Authors: Tanizaki, Yuko; Kobayashi, Aya; Shiro, Michihisa; Ota, Nami; Takano, Rei; Mabuchi, Yasushi; Yagi, Shigetaka; Minami, Sawako; Terada, Masaki; Ino, Kazuhiko
• Is Part Of: International journal of gynecological cancer. Volume 24:Issue 3(2014)
• Page Start: 454
• Page End: 460
• Publication Date: 2014-03-01
• Subjects: FDG-PET/CT -- SUVmax -- Ovarian cancer -- Ovarian borderline malignant tumor -- Histological type; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000074
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: The objective of this study was to investigate the preoperative diagnostic value of 18 F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) in patients with ovarian cancer. Methods: One hundred sixty patients suspected of having malignant ovarian tumors were included in this study. All patients underwent FDG-PET/CT scans before operation, and the maximum standardized uptake value (SUVmax ) of the primary tumor was measured. We evaluated the diagnostic accuracy of SUVmax for detecting malignancy and its relationship with histological findings. Results: Postoperative pathological diagnoses showed that 67 were malignant, 14 were borderline malignant, and 79 were benign tumors. With the use of a cutoff SUVmax of 2.9 obtained from the receiver operating characteristic curve analysis, the sensitivity, specificity, positive predictive value, and negative predictive value for detecting malignancy were 80.6%, 94.6%, 91.5%, and 87.1%, respectively. Positive FDG accumulation (SUVmax ≥ 2.9) was shown in 89.5% of serous adenocarcinoma and in 92.3% of endometrioid adenocarcinoma. In contrast, lower frequencies of positive FDG accumulation were shown in clear cell adenocarcinoma (54.5%), mucinous adenocarcinoma (66.7%), and metastatic carcinoma (66.7%), and the median SUVmax of these 3 histological types were significantly lower than those of serous and endometrioid types. In addition, a positive FDG accumulation was shown in all patients with malignant transformation of mature cystic teratoma. Finally, of the 14 borderline malignant tumors, only 2 (14.3%) showed positive FDG accumulation. Conclusions: The SUVmax on FDG-PET/CT is useful for differentiating ovarian cancer from borderline or benign tumor with a high specificity and positive predictive value. However, our data also demonstrated a lower FDG uptake value in clear cell or mucinous histological finding, suggesting that SUVmax may vary depending on the tumor histological subtype.