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Nuklearmedizin 2015; 54(04): 158-162
DOI: 10.3413/Nukmed-0709-14-11
Original article
Schattauer GmbH

Utility of PET/CT in the diagnosis of recurrent ovarian cancer depending on CA 125 serum level

Nutzen von 18F-FDG PET-CT in der Diagnostik des rezidivierenden Ovarialkarzinoms in Abhängigkeit vom CA-125-Serumspiegel
M. Fularz
1   Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
,
P. Adamiak
1   Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
,
R. Czepczynski
1   Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
2   Department of Nuclear Medicine, Euromedic Diagnostics, Poznan, Poland
,
G. Jarzabek-Bielecka
3   Department of Gynecology, Poznan University of Medical Sciences, Poznan, Poland
,
A. Rewers
1   Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
,
W. Kędzia
3   Department of Gynecology, Poznan University of Medical Sciences, Poznan, Poland
,
M. Ruchała
1   Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
› Author Affiliations
Further Information

Publication History

received: 18 November 2014

accepted in revised form: 26 May 2015

Publication Date:
28 December 2017 (online)

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Summary

The aim of this study was to estimate the diagnostic value of common application of CA 125 level measurement and 18F-FDG PET/CT examination in patients with a suspicion of recurrent ovarian cancer. Patients, methods: A retrospective analysis was performed on a group of 68 patients aged 31–77 (average 57.7) with a suspicion of relapsing ovarian cancer who had CA 125 serum level measurement and PET/CT examination done with a maximum interval of 60 days. Results: PET/CT examination result was positive in 33 patients (48.5%) and negative in 35 (51.5%). Level of CA 125 was significantly higher in women with a positive PET/ CT result than in patients with a negative one (average 199.9 U/ml and 15.7 U/ml, respectively, p < 0.001). Nevertheless, comparison of CA 125 level in groups defined according to the localization of the relapse showed no significant differences. Moreover, the ROC analysis revealed that the optimal cut-off point of CA 125 concentration to predict positive PET/CT result was 17.6 U/ml. Area under the curve was 0.91. Sensitivity, specificity and accuracy in prognosticating positive PET/CT result for the selected cut-off point of 17.6 U/ml were 90.9%, 80.0% and 85.3%, respectively. Conclusion: CA 125 level does not depend on the localization of the recurrence. PET/CT is particularly useful in patients with a suspicion of relapsing ovarian cancer with CA 125 value of at least 17.6 U/ml.

Zusammenfassung

Das Ziel dieser Studie war die Abschätzung des diagnostischen Wertes der gemeinsamen Anwendung von CA-125- Serumspiegelmessung und 18F-FDG PET/CT-Untersuchung bei Patientinnen mit Verdacht auf ein rezidivierendes Ovarialkarzinom. Patienten, Methodik: 68 Patientinnen im Alter von 31–77 Jahren (Durchschnitt 57,7) mit einem Verdacht auf ein rezidivierendes Ovarialkarzinom wurden in die retrospektive Analyse eingeschlossen. Die CA-125-Serumspiegelmessung und PET/CT-Untersuchung wurden mit einem maximalen Abstand von 60 Tagen durchgeführt. Ergebnisse: Die PET/CT war positiv bei 33 Patientinnen (48,5%) und negativ bei 35 (51,5%). Die CA-125-Spiegel waren bei Frauen mit einem positiven PET/CT-Ergebnis signifikant höher als bei Patientinnen mit einem negativen PET/CT (durchschnittlich 199,9 U/ml bzw. 15,7 U/ml, p < 0,001). Dennoch zeigte der Vergleich der CA-125-Spiegel in den Gruppen je nach Lokalisation der Rezidive keine signifikanten Unterschiede. Darüber hinaus ergab die ROC-Kurvenanalyse, dass der optimale Cut-Off-Punkt der CA- 125-Konzentration für eine Voraussage eines positiven PET/CT-Ergebnisses 17,6 U/ml war. Die Fläche unter der Kurve betrug 0,91. Sensitivität, Spezifität und Genauigkeit bei dem ausgewählten Cut-off-Punkt von 17,6 U/ml betrugen: 90,9%, 80,0% bzw. 85,3%. Schlussfolgerungen: PET/CT ist besonders nützlich bei Patientinnen mit Verdacht auf ein rezidivierendes Ovarialkarzinom mit CA- 125-Werten von mindestens 17,6 U/ml. Es gibt keinen Zusammenhang zwischen CA-125-Spiegel und Lokalis.

Keywords

Ovarian cancer - diagnosis - 18F-FDG - PET/CT - CA 125 - recurrence

Schlüsselwörter

Ovarialkarzinom - Diagnostik - 18F-FDG - PET/CT - CA-125 - Rezidiv
 

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