| Purpose:Sixty-two women with adnexal area 18F-FDG uptaking were enrolled to evaluate the diagnostic value of SUVmax and mean CT attenuation value to discriminate malignant from benign ovarian tumors and explore the characteristic of ovarian physiological uptake.Methods:All patients who underwent PET/CT from April 2009 to July 2011 were screened. FDG uptake was quantified by calculating the maximum standardized uptake value (SUVmax) of avid lesion and mean CT attenuation value were also obtained. With the results of histopathological diagnosis or long-term follow-up, we enrolled 62 women who were classified into 4 groups:group of ovarian physiological uptake, group of benign tumor, group of primary ovarian cancer, group of recurrence ovarian cancer and group of ovarian metastases. We combine the first two groups into group of benign lesions while the others were into group of malignant lesions.Results:In group of ovarian physiological uptake,35 women with avid FDG uptake had the PET/CT scan after 8 to 22 days to LMP. One after 43 days was due to the use of hormone and another was after 30 days with irregular of menstrual period. The SUVmax and mean CT attenuation value of group of benign lesions were 6.74±0.33 and 16.09±1.02HU. In group of malignant lesions were 12.86±1.33 and 27.07±1.15HU. Using the unpaired t test, there were significant differences between these two groups (P<0.001). On the basis of the ROC analysis), a cut-off SUVmax of 9.45 was found to best separate benign from malignant ovarian tumors on PET/CT, with a sensitivity, specificity, of 72.0% and 89.2%, respectively and a cut-off mean CT attenuation value of 19.15HU with a sensitivity, specificity, of 96.0% and 70.3%, respectively. However no significance were detected between group of primary ovarian cancer, group of recurrence ovarian cancer and group of ovarian metastases.Conclusion:In conclusion, in 18F-FDG PET/CT scan, SUVmax and mean CT attenuation value had a high diagnostic value in differentiating between malignant and benign ovarian lesions, and a low diagnostic value in differentiating between primary, recurrence and metastases ovarian lesions. Menopause women with avid FDG uptake in the adnexal area are of high suspicion of malignant. And we also recommend a PET/CT may be taken one week after LMP or before next menstrual period in premenopausal women for better interpretation. Objective:To compare the diagnostic performances of computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET or PET/CT) for detection of metastatic lymph nodes in patients with ovarian cancer.Methods:Relevant studies were identified with MEDLINE and EMBASE from January 1990 to July 2010. We estimated the weighted summary sensitivities, specificities, OR (odds ratio), and summary receiver operating characteristic (sROC) curves of each imaging technique and conducted pair-wise comparisons using the two-sample Z-test. Meta-regression, subgroup analysis, and funnel plots were also performed to explain the between-study heterogeneity.Results:Eighteen eligible studies were included, with a total of 882 patients. PET or PET/CT was a more accurate modality (sensitivity,73.2%; specificity,96.7%; OR [odds ratio],90.32). No significant difference was detected between CT (sensitivity, 42.6%; specificity,95.0%; OR,19.87) and MR imaging (sensitivity,54.7%; specificity,88.3%; OR,12.38). Meta-regression analyses and subgroup analyses revealed no statistical difference. Funnel plots with marked asymmetry suggested a publication bias.Conclusion:FDG-PET or FDG-PET/CT is more accurate than CT and MR imaging in the detection of lymph node metastasis in patients with ovarian cancer. |
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