FDG-PET/CT for diagnosis of primary ovarian cancer

Background and aim To evaluate the diagnostic value of integrated (18)F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) to discriminate malignant from benign ovarian tumors. Methods One hundred and eight women suspected of having ovarian cancer underwent preoperative FDG-PET/CT scans. FDG uptake was quantified by calculating the maximum standardized uptake value (SUV(max)) of each tumor. The receiver operating characteristic curve was drawn to determine the optimal cut-off values of SUV(max) that would best discriminate between benign and malignant tumors. Histopathologic results served as the reference standard. We assessed the association between SUV(max) and with International Federation of Gynecology and Obsterics stage in borderline and malignant tumors, using one-factor analysis of variance and an unpaired t test with Bonferoni correction. Results The SUV(max) of benign (n = 26), borderline (n = 12) and malignant (n = 73) lesions was 2.00 +/- 1.02, 2.72 +/- 1.04, and 7.55 +/- 4.29, respectively. Although there were significant differences between benign and malignant, and borderline and malignant lesions (P < 0.0001), there was no significant difference between benign and borderline lesions. Using an SUV(max) cutoff of 2.55, the sensitivity, specificity and accuracy of FDG-PET/CT scanning to detect malignant or borderline tumors were 82.4, 76.9, and 81.1%, respectively. The SUV(max) of stage I (n = 35), stage II (n = 8), stage III (n = 34) and stage IV (n = 8) was 3.59 +/- 2.32, 5.18 +/- 1.34, 8.72 +/- 2.69, and 15.05 +/- 3.77, respectively, and significant differences were observed between SUV(max) values and the various International Federation of Gynecology and Obsterics stage (P < 0.0001). Conclusion FDG-PET/CT scanning has a high diagnostic value in differentiating between malignant and benign tumors, and a low diagnostic value in differentiating between borderline and benign tumors. Nucl Med Commun 32:549-553 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.