Accuracy of 18FDG Positron emission computer tomography (PET-CT) in characterization and preoperative staging of ovarian cancer

Abstract

Background: Ovarian cancer is a challenging disease. Accurate staging and restaging are critical for improving treatment outcomes and determining the prognosis. Imaging is an indispensable component of ovarian cancer management. Hybrid imaging modalities, including positron emission tomography/computed tomography (PET/CT) is emerging as potential non-invasive imaging tools for improved management of ovarian cancer. Methods: This study involved 24 female patients exhibiting increasing CA-125 levels throughout clinical follow-up. All patients underwent comprehensive history taking and clinical evaluation. Then all patients were evaluated using PET-CT scans, the histopathology results served as the gold standard against which the PET-CT results were compared. Results: The CT specificity was 100% and its sensitivity was 75%. PET-CT had 92.9% sensitivity and a 100% specificity rate. When ROC curve analysis is performed on SUV max of the lesion to separate benign from malignant masses, it reveals sensitivity of 89.29%, specificity of 100%, and AUC of 0.911 at the cutoff point of 4.2. When comparing differentiated from poorly differentiated malignant masses, using ROC curve analysis on SUV max to lesion, the results show that the sensitivity is 70.83 percent, the specificity is 100%, and the AUC is 0.708 at a cutoff point of 6.7. Conclusion: FDG PET/CT can greatly impact the evaluation of primary and recurrent ovarian cancer, leading to considerable changes in patient care.