Role of F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125

Objectives: To investigate the role of whole-body fluorine-18-2-deoxy-2-fluoro-d-glucose positron emission tomography/computed tomography (F-FDG PET/CT) in the identification of peritoneal carcinomatosis in patients with ovarian cancer (OC). Material and methods: Seventy-nine patients with histologically proven stages III–IV OC who underwent F-FDG PET/CT were studied retrospectively. We considered group A as 51 patients who also underwent computed-tomography with contrast-enhancement (CECT), and group B as 35 patients who had also been tested for biomarker Ca-125. Sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of F-FDG PET/CT as compared to CECT and to Ca-125 were evaluated. Results: F-FDG PET/CT’ sensitivity, specificity, accuracy, PPV and NPV for all 79 patients were: 85%, 92.31%, 88.61%, 91.89% and 85.71%, respectively. F-FDG PET/CT sensitivity in group A was 78.6%, while it was 53.6% for CECT. F-FDG PET/CT specificity, calculated in the same group, was 91.3%, while that of CECT was 60.9% (statistically significant difference, McNemar 4, P = 0.039). Accuracy was 84.3% and 56.9%, respectively. F-FDG PET/CT’ sensitivity in group B was 86.4%, while that of Ca-125 was 81.8% (no statistical difference, McNemar 0, P = 1). F-FDG PET/CT specificity in group B was 84.6% while that of Ca-125 was 38.5% (clear but not statistically significant difference, McNemar 3.12, P = 0.070). Accuracy calculated in the same group was 85.7% for F-FDG PET/CT and 65.7% for Ca-125. Conclusion: F-FDG PET/CT is a useful diagnostic tool when peritoneal biopsy cannot be performed and it can better select those who are candidates for adjuvant chemotherapy. © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved. Papel del F-FDG PET/CT en el diagnóstico de carcinomatosis peritoneal en la reclasificación de los pacientes con cáncer de ovario en comparación con el TC con contraste y con el marcador tumoral Ca-125