Skip to main content

PET/CT with [18F]FDG in Ovarian Cancer

  • Chapter
  • First Online:

Abstarct

Positron emission tomography/computed tomography (PET/CT) with the use of glucose analogue 2-[18F]fluoro-2-deoxy-d-glucose, [18F]FDG, has a major impact in oncology. Nowadays, there is a growing body of evidence supporting the use of [18F]FDG-PET/CT in gynecological malignancies. Concerning the cervical cancer, imaging with [18F]FDG-PET/CT is not routinely used for the initial diagnosis but the preoperative [18F]FDG uptake in the primary tumor seems to offer significant prognostic information. Also, [18F]FDG-PET/CT is an important tool for initial staging particularly in identifying involved lymph nodes and distant metastasis while it may impact external-beam radiotherapy planning. Finally, it is reported as an important diagnostic tool for detecting recurrent cervical cancer in clinically equivocal patients and for monitoring post-treatment metabolic response. Concerning the ovarian cancer, [18F]FDG-PET/CT is not used for initial diagnosis because of false-positive results but it may contribute to the detection of metastases outside the pelvis in the initial staging. There are published data for the value of [18F]FDG-PET/CT in radiotherapy planning and accurate restaging after treatment, but this method seems to have the greatest utility in ovarian cancer recurrence detection, mainly in patients with an increase of the tumor marker CA-125 and negative or inconclusive findings at CT or MRI. Finally, for the endometrial cancer there are few studies that support that [18F]FDG-PET/CT may play role as a prognostic factor and offer a high accuracy in the evaluation of recurrence.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   179.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   229.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Nakamura K, Hongo A, Kodama J, Hiramatsu Y (2012) The pretreatment of maximum standardized uptake values (SUVmax) of the primary tumor is predictor for poor prognosis for patients with epithelial ovarian cancer. Acta Med Okayama 66:53–60

    PubMed  Google Scholar 

  2. Yuan Y, Gu ZX, Tao XF, Liu SY (2012) Computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with ovarian cancer: a meta-analysis. Eur J Radiol 81:1002–1006

    Article  PubMed  Google Scholar 

  3. Castelluci P, Perrone AM, Picchio M, Ghi T, Farsad M, Nanni C et al (2007) Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer: correlation with transvaginal ultrasonography, computed tomography, and histology. Nucl Med Commun 28:589–595

    Article  Google Scholar 

  4. Yoshida Y, Kurokawa T, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, Yonekura Y, Kotsuji F (2004) Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer. AJR Am J Roentgenol 182:227–233

    Article  PubMed  Google Scholar 

  5. Kitajima K, Murakami K, Yamasaki E (2008) Diagnostic accuracy of integrated FDG-PET/contrast-enhanced CT in staging ovarian cancer: comparison with enhanced CT. Eur J Nucl Med Mol Imaging 35:1912–1920

    Article  PubMed  Google Scholar 

  6. Du XL, Jiang T, Sheng XG, Li QS, Wang C, Yu H (2012) PET/CT scanning guided intensity-modulated radiotherapy in treatment of recurrent ovarian cancer. Eur J Radiol 81:3551–3556

    Article  PubMed  Google Scholar 

  7. Nishiyama Y, Yamamoto Y, Kaneishi K, Ohno M, Hata T, Kushida Y et al (2008) Monitoring the neoadjuvant therapy response in gynecological cancer patients using FDG PET. Eur J Nucl Med Mol Imaging 35:287–295

    Article  PubMed  Google Scholar 

  8. Chung HH, Kang WJ, Kim JW, Park NH, Song YS, Chung JK, Kang SB, Lee HP (2007) Role of [18F]FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clinical or histological findings. Eur J Nucl Med Mol Imaging 34:480–486

    Article  PubMed  Google Scholar 

  9. Hauth EA, Antoch G, Stattaus J, Kuehl H, Veit P, Bosckisch A et al (2005) Evaluation of integrated whole-body PET/CT in the detection of recurrent ovarian cancer. Eur J Radiol 56:263–268

    Article  PubMed  Google Scholar 

  10. Nanni C, Rubello D, Farsad M, De Iaco P, Sansovini M, Erba P et al (2005) 18F-FDG PET/CT in the evaluation of recurrent ovarian cancer: a prospective study on forty-one patients. Eur J Surg Oncol 31:792–797

    Article  PubMed  CAS  Google Scholar 

  11. Simcock B, Neesham D, Quinn M, Drummond E, Milner A, Hicks RJ (2006) The impact of PET/CT in the management of recurrent ovarian cancer. Gynecol Oncol 103:271–276

    Article  PubMed  Google Scholar 

  12. Mangili G, Picchio M, Sironi S, Vigano R, Rabaiotti E, Bornaghi D et al (2007) Integrated PET/CT as a first-line re-staging modality in patients with suspected recurrence of ovarian cancer. Eur J Nucl Med Mol Imaging 34:658–666

    Article  PubMed  CAS  Google Scholar 

  13. Thrall MM, DeLoia JA, Gallion H, Avril N (2007) Clinical use of combined positron emission tomography and computed tomography (FDG-PET/CT) in recurrent ovarian cancer. Gynecol Oncol 105:17–22

    Article  PubMed  Google Scholar 

  14. Kim CK, Park BK, Choi JY, Kim BG, Han H (2007) Detection of recurrent ovarian cancer at MRI: comparison with integrated PET/CT. J Comput Assist Tomogr 31:868–875

    Article  PubMed  Google Scholar 

  15. Sebastian S, Lee SI, Horowitz NS, Scott JA, Fischman AJ, Simeone JF et al (2008) PET-CT vs. CT alone in ovarian cancer recurrence. Abdom Imaging 33:112–118

    Article  PubMed  Google Scholar 

  16. Iagaru AH, Mittra ES, McDougall IR, Quon A, Gambhir SS (2008) 18FFDG PET/CT evaluation of patients with ovarian carcinoma. Nucl Med Commun 29:1046–1051

    Article  PubMed  Google Scholar 

  17. Soussan M, Wartski M, Cherel P, Fourme E, Goupil A, Le Stanc E et al (2008) Impact of FDG PET/CT imaging on the decision making in the biologic suspicion of ovarian carcinoma recurrence. Gynecol Oncol 108:160–165

    Article  PubMed  Google Scholar 

  18. Fulham MJ, Carter J, Baldey A, Hicks RJ, Ramshaw JE, Gibson M (2009) The impact of PET/CT in suspected recurrent ovarian cancer: a prospective multi-centre study as part of the Australian PET data collection project. Gynecol Oncol 112:462–468

    Article  PubMed  CAS  Google Scholar 

  19. Makhija S, Howden N, Edwards R, Kelley J, Townsend DW, Meltzer CC (2002) Positron emission tomography/computed tomography imaging for the detection of recurrent ovarian and fallopian tube carcinoma: a retrospective review. Gynecol Oncol 85:53–58

    Article  PubMed  CAS  Google Scholar 

  20. Bristow RE, DelCarmen MG, Pannu HK, Cohade C, Zahurak ML, Fishman EK et al (2003) Clinically occult recurrent ovarian cancer: patient selection for secondary cytoreductive surgery using combined PET/CT. Gynecol Oncol 90:519–528

    Article  PubMed  Google Scholar 

  21. Sironi S, Messa C, Mangili G, Zangheri B, Aletti G, Garevaglia E et al (2004) Integrated FDG-PET/CT in patients with persistent ovarian cancer: correlation with histologic findings. Radiology 233:433–440

    Article  PubMed  Google Scholar 

  22. Torizuka T, Nobezawa S, Kanno T et al (2002) Ovarian cancer recurrence: role of whole-body positron emission tomography using 2-[fluorine-18]-fluoro-2-deoxy-d-glucose. Eur J Nucl Med Mol Imaging 29:797–803

    Article  PubMed  CAS  Google Scholar 

  23. Gu P, Pan LL, Wu SQ, Sun L, Huang G (2009) CA125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and meta-analysis. Eur J Radiol 71:164–174

    Article  PubMed  Google Scholar 

  24. Nakamoto Y, Saga T, Ishimori T et al (2001) Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. Am J Roentgenol 176:1449–1454

    Article  CAS  Google Scholar 

  25. Prakash P, Cronin CG, Blake MA (2010) Role of PET/CT in ovarian cancer. AJR Am J Roentgenol 194:W464–W470

    Article  PubMed  Google Scholar 

  26. Antunovic L, Cimitan M, Borsatti E, Baresic T, Sorio R, Giorda G, Steffan A, Balestreri L, Tatta R, Pepe G, Rubello D, Cecchin D, Canzonieri V (2012) Revisiting the clinical value of 18F-FDG PET/CT in detection of recurrent epithelial ovarian carcinomas: correlation with histology, serum CA-125 assay, and conventional radiological modalities. Clin Nucl Med 37:e184–e188

    Article  PubMed  Google Scholar 

  27. Kitajima K, Murakami K, Sakamoto S, Kaji Y, Sugimura K (2011) Present and future of FDG-PET/CT in ovarian cancer. Ann Nucl Med 25:155–164

    Article  PubMed  CAS  Google Scholar 

  28. Son H, Khan SM, Rahaman J, Cameron KL, Prasad-Hayes M, Chuang L, Machac J, Heiba S, Kostakoglu L (2011) Role of FDG PET/CT in staging of recurrent ovarian cancer. Radio Graph 31:569–583

    Google Scholar 

  29. Zimny M, Siggelkow W, Schrφder W et al (2001) 2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer. Gynecol Oncol 83:310–315

    Article  PubMed  CAS  Google Scholar 

  30. Sanli Y, Turkmen C, Bakir B, Iyibozkurt C, Ozel S, Has D, Yilmaz E, Topuz S, Yavuz E, Unal SN, Mudun A (2012) Diagnostic value of PET/CT is similar to that of conventional MRI and even better for detecting small peritoneal implants in patients with recurrent ovarian cancer. Nucl Med Commun 33:509–515

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ioannis E. Datseris .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Skoura, E.V., Datseris, I.E. (2014). PET/CT with [18F]FDG in Ovarian Cancer. In: Gouliamos, A., Andreou, J., Kosmidis, P. (eds) Imaging in Clinical Oncology. Springer, Milano. https://doi.org/10.1007/978-88-470-5385-4_41

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5385-4_41

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5384-7

  • Online ISBN: 978-88-470-5385-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics