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Prospective validation of the role of PET/CT in detecting disease after neoadjuvant chemotherapy in advanced ovarian cancer.
Lee, Elaine Yuen Phin; Ip, Philip Pun Ching; Tse, Ka Yu; Chiu, Keith Wan Hang; Chu, Mandy Man Yee; Chai, Yu Ka; Wu, Philip Yuguang; Law, Jessica Yun Pui; Kwok, Shuk Tak; Chiu, Wan Kam; Ngan, Hextan Yuen Sheung.
Afiliação
  • Lee EYP; Department of Diagnostic Radiology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Room 406, Block K, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. eyplee77@hku.hk.
  • Ip PPC; Department of Pathology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • Tse KY; Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • Chiu KWH; Department of Diagnostic Radiology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Room 406, Block K, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.
  • Chu MMY; Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • Chai YK; Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, China.
  • Wu PY; Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
  • Law JYP; Department of Obstetrics and Gynecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
  • Kwok ST; Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • Chiu WK; Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, China.
  • Ngan HYS; Department of Obstetrics and Gynaecology, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China.
Eur Radiol ; 34(9): 5911-5922, 2024 Sep.
Article em En | MEDLINE | ID: mdl-38460014
ABSTRACT

OBJECTIVES:

The study aimed to compare the diagnostic accuracies of 2-[18F]FDG PET/CT and contrast-enhanced CT (ceCT) after neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (OC). MATERIALS AND

METHODS:

This study consisted historical observational cohort and prospective validation cohort. Patients with newly diagnosed stage III-IV OC scheduled for NACT were recruited, with imaging performed after three to six cycles of NACT before interval debulking surgery. Nineteen regions in the abdominopelvic cavity were scored for the presence and absence of disease, referenced to the intra-operative findings or histological specimens. Diagnostic metrics were compared using McNemar's test.

RESULTS:

In the historical cohort (23 patients, age 58 ± 13), 2-[18F]FDG PET had an overall accuracy (Acc) 82%, sensitivity (Sen) 38%, specificity (Spe) 97%, positive predictive value (PPV) 79% and negative predictive value (NPV) 82%; ceCT had an overall Acc 86%, Sen 64%, Spe 93%, PPV 75% and NPV 89%. In the prospective cohort (46 patients, age 59 ± 9), 2-[18F] FDG PET had an overall Acc 87%, Sen 48%, Spe 98%, PPV 84% and NPV 88%; ceCT had an overall Acc 89%, Sen 66%, Spe 95%, PPV 77% and NPV 91%. No significant difference was demonstrated between the two imaging modalities (p > 0.05). High false-negative rates were observed in the right subdiaphragmatic space, omentum, bowel mesentery and serosa. High omental metabolic uptake after NACT was associated with histological non-responders (p < 0.05).

CONCLUSION:

2-[18F]FDG PET/CT had no additional value over ceCT with comparable diagnostic accuracy in detecting disease after NACT in advanced OC. CLINICAL RELEVANCE STATEMENT 2-[18F]FDG PET/CT is not superior to contrast-enhanced CT in determining disease after neoadjuvant chemotherapy in advanced ovarian cancer; contrast-enhanced CT should be suffice for surgical planning before interval debulking surgery. KEY POINTS • Additional value of 2-[18F]FDG PET/CT over contrast-enhanced CT is undefined in detecting disease after neoadjuvant chemotherapy. • 2-[18F]FDG PET/CT has comparable diagnostic accuracy compared to contrast-enhanced CT. • Contrast-enhanced CT will be suffice for surgical planning after neoadjuvant chemotherapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Sensibilidade e Especificidade / Compostos Radiofarmacêuticos / Fluordesoxiglucose F18 / Terapia Neoadjuvante / Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Sensibilidade e Especificidade / Compostos Radiofarmacêuticos / Fluordesoxiglucose F18 / Terapia Neoadjuvante / Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Eur Radiol Assunto da revista: RADIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: China País de publicação: Alemanha