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The performance of contrast-enhanced FDG PET/CT for the differential diagnosis of unexpected ovarian mass lesions in patients with nongynecologic cancer

 Lee, Jeong Won  ;  Lee, Jae-Hoon  ;  Cho, Arthur  ;  Yun, Mijin  ;  Lee, Jong Doo  ;  Kim, Young Tae  ;  Kang, Won Jun 
 CLINICAL NUCLEAR MEDICINE, Vol.40(2) : 97-102, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology* ; Case-Control Studies ; Colorectal Neoplasms/diagnostic imaging ; Colorectal Neoplasms/pathology* ; Contrast Media ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18* ; Humans ; Middle Aged ; Multimodal Imaging ; Ovarian Neoplasms/diagnostic imaging* ; Ovarian Neoplasms/secondary ; Positron-Emission Tomography* ; Radiopharmaceuticals* ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed*
Krukenberg tumor ; ¹⁸F-FDG ; PET ; ovary ; metastasis
PURPOSE: This study aimed to evaluate the diagnostic accuracy of contrast-enhanced FDG PET/CT for unexpected ovarian lesions in patients with nongynecologic cancers.

PATIENTS AND METHODS: The present retrospective study was approved by the hospital institutional review board. We enrolled 72 nongynecologic cancer patients (33 colorectal cancer, 20 breast cancer, and 19 gastric cancer) who showed unexpected ovarian lesions on contrast-enhanced FDG PET/CT and subsequently underwent surgical resection of the ovarian lesions. The SUVmax values of the ovarian lesions were compared according to the histopathological results, and the accuracy of PET/CT was evaluated.

RESULTS: A total of 103 ovarian lesions were surgically resected from 72 patients (64 ovarian lesions were metastases, 21 were benign, and 18 were malignant primary ovarian cancer). SUVmax among the 3 groups were different (P < 0.0001). Using a cutoff SUVmax of 2.5, the sensitivity, specificity, and accuracy of PET/CT for detecting malignant ovarian lesions were 80.5%, 81.0%, and 80.6%, respectively. Detection rates of PET/CT for colorectal, breast, and gastric cancer metastases, as well as primary ovarian cancers were 91.4%, 83.3%, 47.8%, and 100.0%, respectively. Using contrast-enhanced CT findings with SUVmax, the sensitivity, specificity, and accuracy of contrast-enhanced FDG PET/CT were improved to 95.1%, 76.2%, and 91.3%, respectively (P = 0.003).

CONCLUSIONS: Conventional FDG PET/CT showed moderate diagnostic accuracy for the detection of malignant ovarian lesions mainly due to low detection rate in gastric cancer metastases. The PET/CT detection rate of malignant ovarian lesions can be improved using contrast-enhanced CT findings with FDG uptake measurement.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Lee, Jeong Won(이정원)
Lee, Jong Doo(이종두)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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