Recurrent ovarian cancer: Use of contrast-enhanced CT and PET/CT to accurately localize tumor recurrence and to predict patients' survival Journal Article


Authors: Sala, E.; Kataoka, M.; Pandit-Taskar, N.; Ishill, N.; Mironov, S.; Moskowitz, C. S.; Mironov, O.; Collins, M. A.; Chi, D. S.; Larson, S.; Hricak, H.
Article Title: Recurrent ovarian cancer: Use of contrast-enhanced CT and PET/CT to accurately localize tumor recurrence and to predict patients' survival
Abstract: Purpose: To compare accuracy and interobserver variability in the detection and localization of recurrent ovarian cancer with contrast material-enhanced (CE) computed tomography (CT) and positron emission tomography (PET)/CT and determine whether imaging findings can be used to predict survival. Materials and Methods: Waiving informed consent, the institutional review board approved this HIPAA-compliant, retrospective study of 35 women (median age, 54.4 years) with histopathologically proven recurrent ovarian carcinoma who underwent CE CT and PET/CT before exploratory surgery. All CE CT and PET/CT scans were independently analyzed. Tumor presence, number of lesions, and the size and maximum standardized uptake value (SUVmax) of the largest lesion were recorded for patient and region. Surgical histopathologic findings constituted the reference standard. Areas under the receiver operating characteristic curves (AUCs), κ statistics, and hazard ratios were calculated. Results: Readers' AUCs in detection of recurrence for region were 0.85 (95% confidence interval [CI]: 0.81, 0.90) and 0.78 (95% CI: 0.72, 0.83) for CE CT and 0.84 (95% CI: 0.79, 0.89) and 0.74 (95% CI: 0.67, 0.81) for PET/CT (P = .76); 12 patients died. At PET/CT, size, number, and SUVmax of peritoneal deposits were significantly associated with poor survival for readers 1 and 2 (P ≤ .01 and ≤ .05, respectively), as were long- and short-axis diameters, number, and SUVmax of distant lymph nodes for reader 1 (P ≤ .001). With CE CT, size (reader 1) and number (readers 1 and 3) of peritoneal deposits were significantly associated with poor survival (P ≤ .01), as were long- and short-axis diameters and number of distant lymph nodes for reader 1 (P ≤ .01). Interobserver agreement ranged from fair (patient, κ = 0.30) to moderate (region, κ = 0.55) for CE CT and fair (patient, κ = 0.24) to substantial (region, κ = 0.63) for PET/CT. Conclusion: Preliminary data suggest that CE CT and PET/CT may have similar accuracy in detection of recurrent ovarian cancer. Tumor size, number, and SUVmax may have potential as prognostic biomarkers for patients with recurrent ovarian cancer. © RSNA, 2010.
Keywords: adult; cancer survival; clinical article; aged; histopathology; cancer patient; positron emission tomography; recurrent cancer; lymph node metastasis; diagnostic accuracy; biological marker; computer assisted tomography; contrast enhancement; cancer size; ovary carcinoma; peritoneum metastasis
Journal Title: Radiology
Volume: 257
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2010-10-01
Start Page: 125
End Page: 134
Language: English
DOI: 10.1148/radiol.10092279
PROVIDER: scopus
PUBMED: 20697116
PMCID: PMC3726307
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Dennis S Chi
    496 Chi
  2. Chaya S. Moskowitz
    173 Moskowitz
  3. Svetlana Mironov
    37 Mironov
  4. Hedvig Hricak
    333 Hricak
  5. Steven M Larson
    779 Larson
  6. Nicole Marie Leoce
    86 Leoce