Whole-body PET with (fluorine-18)-2-deoxyglucose for detecting recurrent primary serous peritoneal carcinoma: An initial report

Objective. Because of the limited sensitivity and specificity of convention al tools such as computerized tomography (CT) or magnetic resonance imaging (MRI) for detecting persistent or recurrent primary serous peritoneal carc inoma (PSPC), a reliable means of diagnosis remains elusive, Positron emiss ion tomography (PET) scanning may offer another approach to this problem. Methods. A prospective study of three patients requiring surgical explorati on for suspected recurrence of PSPC received a whole-body PET (fluorine-18) -2-deoxyglucose (FDG) scanning in a teaching hospital from July 1995 to Dec ember 1998, The suspected recurrence was based upon clinical findings inclu ding a detailed physical examination, serum CA-125 marker ultrasound, CT, a nd MRI. Three patients were enrolled in this study. Results. In all three patients, PET images demonstrated increased FDG uptak e in a distribution that correlated with surgical-pathologic findings (100% ); on the contrary, CT can detect 33.3% of these patients with malignant di seases and MRI can detect two-thirds of cases. Serum CA-125 was also elevat ed in all three patients, although one patient showed an equivocal elevatio n of 25.7 IU/ml, Conclusions. Conventional imaging studies are neither sensitive nor specifi c for detecting recurrent PSPC. In contrast, besides CA-125, PET might offe r a relatively effective tool for detecting recurrent primary serous perito neal carcinoma. Due to the very small number of patients available in this study, considerable research must be performed to clarify the impact of PET on detecting recurrence of PSPC. (C) 2000 Academic Press.