| Purpose To investigate the value of PET/CT imaging on the therapeutic decision-making and follow-up in the epithelial ovarian cancer patients after surgery and/or combined therapy.Methods 53 epithelial ovarian carcinoma patients were analyzed retrospectively in this study. All the patients received surgery, radiotherapy and/or chemotherapy before PET/CT scans were performed. The PET/CT images were compared with the conventional imaging and the clinical golden standard (postoperative pathobiology and/or long-term clinical follow-up). The value of PET/CT on therapeutic decision-making and overall survival was investigated. ROC analysis was performed for the cutoff value of SUVmax which related to recurrence of malignant tumors and kaplan-Meier analysis by log-rank tests for survival analysis. it was statistic significant with p <0.05.Results: According to 53 ovarian cancer patients, 33 cases were final diagnozed recurrence or metastasis, and the rest 20 patients disease-free after long-term clinical follow-up. According to PET/CT imaging, 36 cases were diagnozed metastasis/recurrence (31 true-positive cases and 5 false-positive cases), and 17 cases had negative findings (2 false-negative cases.) Compared with the golden standard, the diagnostic sensitivity, specificity, accuracy,Positive predictive value and Negative predictive value were 93. 94%,75.00%, 86.79%, 81.11%, 88.23% respectively.for PET/CT imaging, and 69. 70%,60.00%, 66.04%, 74.19% and 54.55% for conventional imaging. There were significant differences between the PET imaging and CMI on sensitivity Results (X2=6.519 P=0.011)and no significant differences with CA125 values(X2=3.216 P=0.073). ROC curve analysed SUVmax value of PET / CT and the area under the curve was 0.860. When the SUV was 5.7, the prediction in relapse of disease with sum of sensitivity and specificity reached maximum and the Youden index was 0.574. Compared with previously proposed treatment plan, therapy methods were changed in 16 patients (31%) werw therapy based on PET / CT results. Kaplan-Meier survival curve in true-positive patients and true-negative showed that median survival time of true-positive patients was 35 months (95% CI 28.227-41.773, shorter true-negative patients 48 month(95% CI 31.645-64.355)and both are statistically significant (P = 0.039 log-rank test).Conclusion 18F-FDG PET/CT imaging could be used for following-up of ovarian cancer patients. The diagnostic value of PET/CT imaging in monitoring metastasis and recurrence was much higher than that of conventional imaging. treatment methods were changed in 31% patients in this study. sensitivity and specificity after diagnosis of recurrence were obtained maximum when SUV cutoff value of 5.7; PET / CT in the diagnosis of the patient's survival may be a factor in the prognosis. |
PDF Full Text Request