2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer

Objective. The aim of the study was to investigate the role of 2-[fluorine- 18]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) in the diagnosis of recurrent ovarian cancer. Methods. One hundred six FDG PET scans performed in 54 patients in the foll ow-up after cytoreductive surgery and chemotherapy of ovarian cancer were r eevaluated. Fifty-eight scans were performed in patients with suspected rec urrence and 48 scans in patients who were clinically disease free. Thirty-s even PET scans were validated by histology and 66 studies by a median follo w-up of 22 months in disease-free patients or 12 months in patients with re current disease. Three scans were validated by concordant positive findings of tumor marker CA125, computed tomography, and FDG PET. Results. FDG PET correctly identified recurrent disease in 73/88 cases. PET ruled out recurrent disease in 15/18 cases. The sensitivity, and specifici ty for PET were 83 and 83%, respectively. In patients with suspected diseas e, sensitivity, was 94% compared to 65% in patients judged clinically disea se free. The sensitivity of PET was 96% if suspicion of recurrence was base d on a rise of CA125 alone. PET preceded the conventional diagnosis by a me dian of 6 months in patients judged clinically free of disease. The median relapse-free interval after a negative PET scan was 20 months. Conclusion. FDG PET provides the chance to detect recurrent ovarian cancer at an earlier stage during follow-up. Patients with a negative PET scan hav e a longer relapse-free interval than patients with a positive PET scan. (C ) 2001 Academic Press.