scholarly journals To Enhance or Not to Enhance? The Role of Contrast Medium 18F-FDG PET/CT in Recurrent Ovarian Carcinomas

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 561
Author(s):  
Michela Massollo ◽  
Francesco Fiz ◽  
Gianluca Bottoni ◽  
Martina Ugolini ◽  
Francesco Paparo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Contrast Medium ◽  
Predictive Value ◽  
Ground Truth ◽  
Ovarian Carcinomas ◽  
Positron Emission ◽  
Pet Ct ◽  
Lesion Level ◽  
Sensitivity Specificity

Background and Objectives: 18F-fluorodeoxyglucose (FDG) positron emission tomography/X-ray computed tomography (PET/CT) represents the mainstay diagnostic procedure for suspected ovarian cancer (OC) recurrence. PET/CT can be integrated with contrast medium and in various diagnostic settings; however, the effective benefit of this procedure is still debated. We aimed to compare the diagnostic capabilities of low-dose and contrast-enhanced PET/CT (PET/ldCT and PET/ceCT) in patients with suspected ovarian cancer relapse. Materials and Methods: 122 OC patients underwent both PET/ldCT and PET/ceCT. Two groups of nuclear medicine physicians and radiologists scored the findings as positive or negative. Clinical/radiological follow-up was used as ground truth. Sensitivity, specificity, negative/positive predictive value, and accuracy were calculated at the patient and the lesion level. Results: A total of 455 and 474 lesions were identified at PET/ldCT and PET/ceCT, respectively. At the lesion level, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were not significantly different between PET/ldCT and PET/ceCT (98%, 93.3%, 97.4%, 94.9%, and 96.9% for PET/ldCT; 99%, 95.5%, 98.3%, 97%, and 98% for PET/ceCT, p = ns). At the patient level, no significant differences in these parameters were identified (e.g., p = 0.22 and p = 0.35 for accuracy, in the peritoneum and lymph nodes, respectively). Smaller peritoneal/lymph node lesions close to physiological FDG uptake sources were found in the cases of misidentification by PET/ldCT. PET/ceCT prompted a change in clinical management in four cases (3.2%) compared to PET/ldCT. Conclusions: PET/ceCT does not perform better than PET/ldCT but can occasionally clarify doubtful peritoneal findings on PET/ldCT. To avoid unnecessary dose to the patient, PET/ceCT should be excluded in selected cases.

Diagnostic Value of WB-DWI Versus 18 F-FDG PET/CT for the Detection of Multiple Myeloma

2020 ◽  
Author(s):  
Bei Zhang ◽  
Li Zhang ◽  
Bingyang Bian ◽  
Fang Lin ◽  
Zining Zhu ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Fdg Pet ◽  
Pet Ct ◽  
Adc Values ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Abstract BACKGROUND Whole body diffusion weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with 18 F positron emission tomography computed tomography ( 18 F-FDG PET/CT) to detect MM are lacking. METHODS This was a retrospective, single-center study of twenty-two patients with MM enrolled from January 2019 to December 2019. All patients underwent WB-DWI and 18 F-FDG PET/CT. Pathological and clinical manifestations as well as radiologic follow-up were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of both methods were compared. The appearance diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. RESULTS A total of 214 MM bone lesions were evaluated. WB-DWI showed a higher overall accuracy than PET/CT (75.7% and 55.6%, respectively; < 0.05). However, for sensitivity, specificity, positive predictive value and negative predictive value, there were no significant differences for WB-DWI vs PET/CT (99.3% and 83.9%, 64.9% and 94.8%, 63.6% and 54.2%, 98.1% and 65.3%, respectively). The ADC value for MM lesions was significantly lower than that for false-positive lesions (p < 0.001). Receiver operating curve (ROC) curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745×10 -3 mm 2 /s, the sensitivity and specificity were 86.0% and 82.4%, respectively, which distinguished MM lesions from non-MM lesions. CONCLUSION WB-DWI may be a useful tool for the diagnosis of MM bone disease due to to higher overall accuracy and measurements of ADC values compared with PET/CT.

scholarly journals Evaluation of the Accuracy of Human Kallikrein6, Cancer Antigen125, and Human Epididymis 4 in Predicting Ovarian Cancer

2017 ◽  
pp. 110
Author(s):  
Yongki Wenas ◽  
Ketut Suwiyoga ◽  
I Nyoman H Sanjaya
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cancer Antigen 125 ◽  
Chi Square ◽  
Cross Sectional ◽  
Human Epididymis ◽  
Sensitivity Specificity ◽  
Histopathology Examination

Objective: To evaluate the accuracy of hK6, HE4, and CA125 in predicting the malignancy of ovarian mass. Methods: The design of this study was cross-sectional. This study was conducted in the Obstetrics and Gynecology Clinic, Sanglah Hospital, Denpasar, between the period of September 2014 and August 2016. Samples were all patients with ovarian tumors who underwent surgery at Sanglah Hospital, Denpasar. Data analysis was performed using McNemar and chi square test in SPSS for windows version 17.0. Results: 22 samples were obtained. P > 0.05 value of age and parity variables indicated no differences between the two groups. There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of hK6 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of HE4 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy difference (sensitivity, specificity, positive predictive value, negative predictive value) of CA125 compared to histopathology examination in diagnosing ovarian cancer (p = 0.687). Conclusion: There was no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) found between hK6, CA125, HE4 compared to histopathology examination in predicting ovarian cancer. [Indones J Obstet Gynecol 2017; 5-2: 110-113] Keywords: cancer antigen 125, human epididymis-4, human kallikrein 6, ovarian cancer

scholarly journals SENSITIVITY AND SPESIFICITY VALUE OF PLATELETS, MALIGNANCY RATIO INDEX AND BOTH COMBINED IN DIAGNOSING OVARIAN CANCER AT GENERAL HOSPITAL HAJI ADAM MALIK MEDAN FROM 2016-2018

2020 ◽  
pp. 121-125
Author(s):  
YOVITA V. ◽  
TALA MRZ ◽  
DINA S. ◽  
LUMBANRAJA S. N. ◽  
LUBIS D. L. ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
General Hospital ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Benign Tumors ◽  
Test Design ◽  
Ovarian Mass ◽  
Diagnostic Modality ◽  
Sensitivity Specificity

Objective: This research aimed to analyze sensitivity and specificity values of platelets, RMI and both combined as ovarian cancer diagnostic modality in Haji Adam Malik Hospital in 2016-2018. Methods: This is analytic research with a diagnostic test design on 204 patients who had been diagnosed with ovarian cancer and patients with ovary benign tumors which have been examined the value of full blood and the malignancy ratio index and ovarian mass that has been proven by the results of anatomic pathology at General Hospital Haji Adam Malik Medan in 2016-2018. The data is tabulated into 2x2 table and then calculated for each sensitivity, specificity, positive predictive value and negative predictive value. Result: By using platelet cut-off value>450000 per mm3 in diagnosing ovarian cancer with sensitivity 55.44% and specificity 83.65% were obtained. IRK has a sensitivity 83.16% and specificity 76.92%. Platelet and IRK values ​​provided the highest diagnostic value (specificity) compared to when they were each single which was 97.11% while the combination of platelet and IRK values ​​had a sensitivity of 49.50%. Conclusion: Platelet and IRK values ​​gives the highest diagnostic value (specificity) compared to when both are used, namely 97.11%.

ATL

2014 ◽  
Vol 24 (3) ◽  
pp. 454-460 ◽  
Author(s):  
Yuko Tanizaki ◽  
Aya Kobayashi ◽  
Michihisa Shiro ◽  
Nami Ota ◽  
Rei Takano ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Clear Cell ◽  
Benign Tumors ◽  
Clear Cell Adenocarcinoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Fdg Accumulation

ObjectiveThe objective of this study was to investigate the preoperative diagnostic value of18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) in patients with ovarian cancer.MethodsOne hundred sixty patients suspected of having malignant ovarian tumors were included in this study. All patients underwent FDG-PET/CT scans before operation, and the maximum standardized uptake value (SUVmax) of the primary tumor was measured. We evaluated the diagnostic accuracy of SUVmaxfor detecting malignancy and its relationship with histological findings.ResultsPostoperative pathological diagnoses showed that 67 were malignant, 14 were borderline malignant, and 79 were benign tumors. With the use of a cutoff SUVmaxof 2.9 obtained from the receiver operating characteristic curve analysis, the sensitivity, specificity, positive predictive value, and negative predictive value for detecting malignancy were 80.6%, 94.6%, 91.5%, and 87.1%, respectively. Positive FDG accumulation (SUVmax≥ 2.9) was shown in 89.5% of serous adenocarcinoma and in 92.3% of endometrioid adenocarcinoma. In contrast, lower frequencies of positive FDG accumulation were shown in clear cell adenocarcinoma (54.5%), mucinous adenocarcinoma (66.7%), and metastatic carcinoma (66.7%), and the median SUVmaxof these 3 histological types were significantly lower than those of serous and endometrioid types. In addition, a positive FDG accumulation was shown in all patients with malignant transformation of mature cystic teratoma. Finally, of the 14 borderline malignant tumors, only 2 (14.3%) showed positive FDG accumulation.ConclusionsThe SUVmaxon FDG-PET/CT is useful for differentiating ovarian cancer from borderline or benign tumor with a high specificity and positive predictive value. However, our data also demonstrated a lower FDG uptake value in clear cell or mucinous histological finding, suggesting that SUVmaxmay vary depending on the tumor histological subtype.

Clinical impact of positron emission tomography or positron emission tomography/computed tomography in the posttherapy surveillance of endometrial carcinoma: evaluation of 88 patients

2008 ◽  
Vol 18 (6) ◽  
pp. 1332-1338 ◽  
Author(s):  
J.-Y. Park ◽  
E. N. Kim ◽  
D.-Y. Kim ◽  
J.-H. Kim ◽  
Y.-M. Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Clinical Impact ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Sensitivity Specificity

The objective of this study was to evaluate the validity and clinical impact of positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) using 18-fluoro-2-deoxy-D-glucose in the posttherapy surveillance of patients with endometrial carcinoma. Eighty-eight patients previously treated for histopathologically diagnosed endometrial adenocarcinoma underwent 99 PET or PET/CT scans at follow-up visits at Asan Medical Center, Seoul, Korea, between 2001 and 2007. The standard of reference for tumor recurrence consisted of histopathologic confirmation or follow-up information at least 6 months after PET or PET/CT. Of the 88 patients, 24 underwent PET (n= 11) and/or PET/CT (n= 14) scans due to suspected disease recurrence. The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of PET and/or PET/CT in detecting recurrence in these patients were 100%, 83.3%, 96%, 95%, and 100%, respectively. Especially, PET/CT revealed true-positive findings in three patients with elevated tumor markers but negative CT findings. The remaining 64 patients underwent PET (n= 8) and/or PET/CT (n= 66) as part of routine posttherapy surveillance; these patients were asymptomatic, with no evidence of disease. The sensitivity, specificity, accuracy, PPV, and NPV of PET and/or PET/CT in detecting recurrence in these patients were all 100%. Clinical decisions on treatment were changed in 14 (21.9%) patients by introducing PET or PET/CT into their conventional posttherapy surveillance program. PET and/or PET/CT were highly effective in discriminating true recurrence in patients with suspected recurrence, highly sensitive in detecting recurrence in asymptomatic patients, and had impacts on clinical decisions in a considerable portion of patients.

The Clinical Value of 68Ga-FAPI-04 PET/CT on Detection of Lymph Node Metastasis and Staging for Esophageal Carcinoma

2021 ◽  
Author(s):  
Xiao Yang ◽  
Zhouxiang You ◽  
Lin Liu ◽  
Lei Lei ◽  
Chungru Mou ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Positive Predictive Value ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Node Metastasis ◽  
Pet Ct ◽  
Enhanced Ct ◽  
Sensitivity Specificity

Abstract Purpose To observe the clinical application value of 68Ga-FAPI-04 PET/CT in the preoperative detection of lymph node metastasis and staging of esophageal cancer.Methods A prospective analysis of 29 surgical patients was performed. 68Ga-FAPI-04 PET/CT was performed within 1 week before the operation. All patients received enhanced CT during the same period. None of these patients had received preoperative treatment before the operation. The value of 68Ga-FAPI-04 PET/CT and enhanced CT in the diagnosis of lymph node metastasis and preoperative staging of esophageal cancer was compared according to postoperative pathology.Results Both 68Ga-FAPI-04 PET/CT and CT detected the primary tumor (29/29 cases). 637 lymph nodes were surgically removed, of which 37 lymph nodes were metastasized. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for lymph node metastasis detection were 71.1%, 99.4%, 97.8%, 90.0%, and 98.2%; The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT for lymph node metastasis detection were 36.8%, 98.9%, 95.3%, 70.0%, and 96.1%, respectively.Conclusion 68Ga-FAPI-04 PET/CT is better than enhanced CT in diagnosing lymph node metastasis and determining lymph node staging in esophageal cancer.

scholarly journals Radiological Imaging for Assessing the Respectability of Hilar Cholangiocarcinoma: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Hongchen Zhang ◽  
Jian Zhu ◽  
Fayong Ke ◽  
Mingzhe Weng ◽  
Xiangsong Wu ◽  
...  
Keyword(s):  
Predictive Value ◽  
Hilar Cholangiocarcinoma ◽  
Imaging Modality ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Efficiency ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Hilar cholangiocarcinoma (HCC) remains one of the most difficult tumors to stage and treat. The aim of the study was to assess the diagnostic efficiency of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computer tomography (PET/CT) in evaluating the resectability of HCC. A systematic search was performed of the PubMed, EMBASE, and Cochrane databases. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for individual studies and pooled data as well as test for heterogeneity and public bias. Our data showed that CT had the highest pooled sensitivity at 95% (95% CI: 91–97), whereas PET/CT had the highest pooled specificity at 81% (95% CI: 69–90). The area under the curve (AUC) of CT, MRI, and PET/CT was 0.9269, 0.9194, and 0.9218, respectively. In conclusion, CT is the most frequently used imaging modality to assess HCC resectability with a good sensitivity and specificity. MRI was generally comparable with that of CT and can be used as an alternative imaging technique. PET/CT appears to be the best technique in detecting lymph node and distant metastasis in HCC but has no clear role in helping to evaluate issues of local resectability.

scholarly journals ROLE OF INTEGRATED PET/CT IN DETECTING RECURRENT OVARIAN CANCER IN PATIENTS WITH RISING CA-125 LEVELS

2015 ◽  
Vol 1 (2) ◽  
Author(s):  
Fozia Naz ◽  
Ahmed Murtaza ◽  
Khurram A Mufti ◽  
Zia S. Faruqui ◽  
Humayun Bashir
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Recurrent Ovarian Cancer ◽  
Emission Tomography ◽  
Ca 125 ◽  
Positron Emission ◽  
Response To Chemotherapy ◽  
Pet Ct

Purpose: The purpose of this study was to assess the sensitivity and diagnostic accuracy of integrated positron emission tomography/computed tomography (PET/CT) in detecting recurrent ovarian cancer in treated patients presenting with rising CA-125 levels during clinical follow-up and compare it with those of CT alone. Materials and Methods: This was a retrospective study. We evaluated 45 patients with pathologically proven ovarian carcinoma who underwent PET/CT during October 2010–November 2013 at our institution for suspected relapse; IRB deemed that approval for this retrospective study was not required. Of these, 35 patients who presented with rising CA-125 levels during clinical follow-up were included in this study. Remaining 10 patients were excluded as they had normal CA-125 levels. At least three previous consecutive CA-125 readings and initial conventional imaging before uorodeoxyglucose-PET/CT were noted. Sensitivity and diagnostic accuracy for tumour detection with PET/CT and CT alone were calculated; histological analysis after biopsy/second look surgery or clinical- radiologic follow-up/response to chemotherapy was taken as reference standard. K statistics (Cohen K) was used for statistical analysis. Results: Of 35 patients with suspected relapse, one patient was lost to follow up. 30 patients were documented to have relapsed, while in four patients, recurrence was not identi ed either on CT or PET-CT and they were proved to be disease free on 2-year follow-up. Amongst these relapsed patients, 10/30 cases were proven histologically, 3 with imaging-guided biopsy and 7 with second-look surgery, whereas 20/30 were con rmed on clinical/radiological follow-up (ranging from 3 to 6 months) or by response to chemotherapy on subsequent imaging. Of 30 patients with relapse, PET-CT highlighted recurrence in 27. Sensitivity, speci city, positive predictive value, negative predictive value, and diagnostic accuracy of integrated PET/CT were calculated to be 90%, 75%, 96%, 50%, and 88%, respectively. CT alone detected recurrence in 20 patients. Sensitivity, speci city, positive predictive value, negative predictive value, and diagnostic accuracy of CT were calculated to be 73.3%, 100%, 100%, 33%, and 76%, respectively. Conclusion: PET/CT is a highly sensitive and accurate post-therapy surveillance modality for the detection of recurrent ovarian cancer in patients with rising tumour markers as compared to CT alone. Key words: CA125, uorodeoxyglucose, ovarian cancer, positron emission tomography/computed tomography, recurrence

scholarly journals Can High b Value Diffusion Be a Surrogate Marker for PET—A MR/PET Study in Neurooncology Set Up

2021 ◽  
Vol 12 ◽  
Author(s):  
Sandhya Mangalore ◽  
Sriharish Vankayalapati ◽  
Shumyla Jabeen ◽  
Arun Kumar Gupta ◽  
Pardeep Kumar
Keyword(s):  
Positron Emission Tomography ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Whole Body ◽  
Diagnostic Tools ◽  
Positron Emission ◽  
Sensitivity Specificity

Purpose: Hybrid whole-body magnetic resonance/positron emission tomography (MR/PET) systems are new diagnostic tools enabling the simultaneous acquisition of morphologic and multiparametric functional data, which allow for a diversified characterization of oncological diseases. This study aimed to compare the diagnostic ability of MRI with the diffusion-weighted image (DWI), and simultaneous integrated positron emission tomography MR/PET to detect malignant lesions and elucidate the utility and limitations of these imaging modalities in preoperative and postoperative follow up in cancer patients.Material and Methods: A total of 45 patients undergoing simultaneous MR/PET for CNS ICSOL in our institution between January 2016 and July 2020 were considered in this study. Post-processing was done in Siemens syngo software to generate a b2000 image. This image was then inverted to grayscale and compared with the NAC image of PET.Results: The lesion-based sensitivity, specificity, positive predictive value, and negative predictive value for DWI were 92.3, 83.3, 97.3, and 62.5%, respectively (at 95% CI and p was 0.000). The lesion-based sensitivity, specificity, positive predictive value, and negative predictive value for PET were 97.4, 71.4, 94.9, and 83.3%, respectively (at 95% CI and p was 0.000). The lesion-based sensitivity and specificity of DWI were comparable with those of PET.Conclusions: Although DWI and FDG-PET reflect different tissue properties, there is an association between the measures of both methods in CNS tumors probably because of the coupling of cellularity with tumor metabolism as seen on FDG and other PET tracers. Our study shows that DWI acts as a surrogate biomarker for FDG PET and other tracers in tumors. The method of DWI image generation is simple, radiation-free, and cost-effective in a clinical setup. The simultaneous DWI-PET study provides evidence and confirms the role of DWI in surveillance imaging of tumors.

Sign in / Sign up

Export Citation Format

Share Document