PET/CT in the staging of patients with a pelvic mass suspicious for ovarian cancer

• We performed a prospective analysis of the value of PET/CT in patients with a suspected ovarian mass.
• PET/CT is better than CT in detecting retroperitoneal lymph node metastases, but not for intraperitoneal metastases.

ObjectiveTo prospectively assess the value of PET/CT for staging, diagnosis and operability of ovarian cancer, with special attention to the peritoneal spread.MethodsFrom June 2009 to March 2011, 69 patients with suspicion of having an ovarian cancer underwent an 18 F-FDG PET/CT. To identify the diagnostic value of PET/CT, the results were compared with the findings at diagnostic laparoscopy and/or debulking surgery.ResultsThere were 56 patients with malignant tumors and 13 with benign tumors. We observed a sensitivity and specificity of 93% and 77%, respectively for malignant tumors with PET/CT. CT alone had a sensitivity and specificity of 96% and 38%, respectively. The overall FIGO classification evaluation for PET/CT and CT were the same. For the evaluation of metastases, the sensitivity of PET/CT was worse, while the specificity was better than CT. Retroperitoneal lymph node metastases were diagnosed better with PET/CT, while there was no difference for peritoneal spread and for the intestines. PET/CT detected another unknown primary tumor in 3 (4.3%) cases.ConclusionPET/CT is better than CT in detecting retroperitoneal lymph node metastases, but not for peritoneal metastases.