Investigation of 18F-FDG PET/CT Findings and CA-125 Levels in Ovarian Cancer Staging
Reşit AKYEL1,Elife AKGÜN2,Burak AKOVALI3,Onur Erdem ŞAHİN4,Sait SAĞER5,Abdullah Serdar AÇIKGÖZ6,Zübeyde Rana KAYA DÖNER7,Kerim SÖNMEZOĞLU5
1Department of Nuclear Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul-Turkey
2Department of Nuclear Medicine, Kirikkale High Specialization Hospital, Kirikkale-Turkey
3Department of Nuclear Medicine, Erzurum Regional Training and Research Hospital, Erzurum-Turkey
4Department of Nuclear Medicine, Sivas Numune Hospital, Sivas-Turkey
5Department of Nuclear Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul-Turkey
6Department of Gynecology and Obstetrics, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul-Turkey
7Department of Nuclear Medicine, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa-Turkey
DOI : 10.5505/tjo.2022.3431 OBJECTIVE
This study aims are to investigate the role of 18F labeled fluoro-2-deoxy-D-glucose positron emission computed tomography/computed tomography (18F FDG PET/CT) in the initial staging and recurrence detection of ovarian cancer and to compare it with the cancer antigen-125 (CA-125) value.

A total of 93 patients with a primary ovarian cancer diagnosis (Group 1 n=41) or suspicion of recurrent ovarian cancer (Group 2 n=52) were included in this study from January 2007 to January 2013.

The ages of the patients were between 15 and 82 years. In cases with PET positive lesions (n=84); Ovarian lesion (n=34), infradiaphragmatic lymph node metastasis (n=46), supradiaphragmatic lymph node metastasis (n=14), peritoneal implant (n=67), and distant metastasis (n=14) were detected. Histopathological examination of 4 PET positive ovarian lesions was not compatible with cancer. In 14 cases with low CA-125 value, 18F FDG PET/CT was able to detect primary/recurrent lesions accurately. In the evaluation of primary/recurrent ovarian cancer, 18F FDG PET/CT had 93% sensitivity, 42.8% specificity, 89.2% accuracy, whereas CA-125 had 79.1% sensitivity, 42.8% specificity, and 76.3% accuracy.

In conclusion; even in low CA-125 values, 18F FDG PET/CT is a prominent method that can detect especially extra-abdominal distant metastatic foci in the initial staging of primary ovarian cancer and diagnosis and follow-up of recurrent ovarian cancer. Keywords : 18F labeled fluoro-2-deoxy-D-glucose; cancer antigen-125; ovarian cancer; positron emission tomography/ computed tomography; SUVmax