Negative 18F-2-fluorodeoxyglucose PET/CT predicts good cancer specific survival in patients with a suspicion of recurrent ovarian cancer

Abstract

Aim: The aim of the present study was to investigate the diagnostic and prognostic value of combined (18)F-2-fluorodeoxyglucose positron emission tomography and contrast enhanced X-ray computed tomography (FDG-PET/CT) in women with a suspicion of recurrent ovarian cancer.

Patients and methods: We retrospectively reviewed 48 patients with a suspicion of recurrent ovarian cancer who were referred to our department for combined FDG-PET/CT.

Results: Median follow-up was 25 months. 38/48 (79%) patients showed pathological findings on PET/CT. 17/48 (35%) of patients died of ovarian cancer. One FDG-PET/CT was false positive and one was false negative, leading to a sensitivity and positive predictive value of 97% and a specificity and negative predictive value of 90%. 33/48 (69%) underwent a change in therapy following FDG-PET/CT. There was a significantly better survival in FDG-PET/CT negative than in positive patients (p=0.04). In the FDG-PET/CT negative group no patients had died of ovarian cancer during follow-up. Remarkably, there was no difference in survival between patients who only had peritoneal metastases on FDG-PET/CT and those who also had extraperitoneal metastases (p=0.71).

Conclusion: A negative FDG-PET/CT has a high negative predictive value for the presence of disease and, more importantly, is associated with a very good disease-specific survival rate.

Keywords: FDG-PET/CT; Ovarian cancer; Prognosis.