CT AND MR ACCURACY IN THE DETECTION OF TUMOR RECURRENCE IN PATIENTS TREATED FOR OVARIAN-CANCER

Objective The aim of this prospective study was to evaluate the accura cy of clinical examinations (palpation/determination of serum tumor-as sociated antigen CA125 level), CT, and MRI in the detection of tumor r ecurrence in patients with treated ovarian cancer. Materials and Metho ds: Twenty-four patients who had been treated for ovarian carcinoma we re prospectively examined by clinical means (palpation/serum tumor-ass ociated antigen CA125 level), CT, and MRI to assess their accuracy in detecting recurrent disease; results were correlated with surgical/bio ptic/pathoanatomic findings. Nine patients had relapse; 15 women were disease-free. Results: Examinations were true-negative in 14 patients (on palpation/CA125, CT, and MRI) and true-positive in 9 on palpation/ CA125, in 6 on CT, and in 7 patients on MRI. False-positive examinatio ns occurred in one patient on palpation/CA125, CT, and MRI and false-n egative in zero on palpation/CA125, in three on CT, and in two on MRI, a sensitivity of 100% for palpation/CA125, 66.6% for CT, and 77.7% fo r MRI and a specificity of 93.3% for palpation/CA125, CT, and MRI. Acc uracy of palpation/CA125 examinations was 95.8% in comparison with 83. 3% for CT and 87.5% for MRI. Conclusion: Our results suggest that in t he follow-up of ovarian cancer patients, assessment of serum tumor-ass ociated antigen CA125 level is accurate in the determination of patien ts with tumor recurrence. Computed tomography is the primary imaging m odality to prove macroscopic disease recurrence and can spare these pa tients from invasive restaging second-look laparotomy; MRI should be p erformed in women with questionable macroscopic recurrent tumor and ne gative CT examination. Neither CT nor MRI can confidently exclude micr oscopic disease.