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

2015 ◽  
Vol 54 (04) ◽  
pp. 158-162 ◽  
Author(s):  
M. Fularz ◽  
P. Adamiak ◽  
R. Czepczynski ◽  
G. Jarzabek-Bielecka ◽  
A. Rewers ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Serum Level ◽  
Area Under The Curve ◽  
Recurrent Ovarian Cancer ◽  
Diagnostic Value ◽  
Ca 125 ◽  
Ct Examination ◽  
Level Measurement ◽  
Pet Ct ◽  
Sensitivity Specificity

SummaryThe 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.

scholarly journals Diagnostic accuracy of PET/CT scan in evaluation of clinically suspected recurrent ovarian cancer

2021 ◽  
Vol 14 (4) ◽  
pp. 156-160
Author(s):  
Nimrah Sultana ◽  
Shaista Shoukat ◽  
Sadaf Nausheen ◽  
Bakhtawar Memon
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Accuracy ◽  
Ovarian Carcinoma ◽  
Ct Scan ◽  
Tumor Marker ◽  
Recurrent Ovarian Cancer ◽  
Ca 125 ◽  
Pet Ct ◽  
Suspected Recurrence ◽  
Pet Ct Scan

Background: Accurate evaluation of ovarian carcinoma is utmost important for effective management. PET/CT is reported to be effective in evaluation of suspected recurrence of ovarian carcinoma. This study aims to assess the accuracy of PET/CT in evaluation of recurrent ovarian cancer among clinically suspected cases with rising tumor marker or suspicious clinic-radiological findings. Patients and methods: This prospective cross-sectional study was conducted at Radiology department of Jinnah Postgraduate Medical Centre Karachi from 22nd April 2019 to 21st April 2020. Patients having age of 40 to 60 years and referred for PET scan with suspected recurrence of ovarian carcinoma were consecutively enrolled. Patients were suspected due to relevant history, clinical findings and initial imaging investigations with elevated CA-125 level. Results of 18FDG PET/CT scan was correlated with the raised tumor findings. The PET/CT scan showing abnormally elevated FDG take-up and higher SUV values than the background activity considered recurrence. Diagnostic accuracy of PET/CT was calculated taking raised tumor level as reference category. Results: Of 65 patients, median age was 50 (43-56) years. The findings showed positive cases in 57 (87.7%) while negative in 8 (12.3%) patients, whereas the findings of tumor marker showed raised tumor marker in 61 (93.8%) patients. Diagnostic accuracy of PET/CT showed sensitivity, specificity, positive predicted value, negative predated value, and overall diagnostic accuracy as 93.44%, 100%, 100%, 50%, and 93.85% respectively. Conclusion: A higher accuracy of PET/CT was observed in the diagnosis of recurrent ovarian cancer among clinically suspected cases, thus helping in devising an appropriate management plan by the treating physician.

Correlation between CA-125 serum level and response by RECIST in a phase III recurrent ovarian cancer study

2011 ◽  
Vol 122 (2) ◽  
pp. 350-355 ◽  
Author(s):  
Thomas J. Herzog ◽  
Jan B. Vermorken ◽  
Eric Pujade-Lauraine ◽  
Diane M. Provencher ◽  
Agnieszka Jagiello-Gruszfeld ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Serum Level ◽  
Recurrent Ovarian Cancer ◽  
Phase Iii ◽  
Ca 125 ◽  
Cancer Study

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 Evaluation of Recurrent Ovarian Cancer: An Evolution

2019 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Norazlina Mat Nawi ◽  
Irfan Mohamad
Keyword(s):  
Ovarian Cancer ◽  
Recurrent Ovarian Cancer ◽  
Health Sciences ◽  
Emission Tomography ◽  
Ca 125 ◽  
Radiological Imaging ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Pet Ct ◽  
Higher Sensitivity

Ovarian cancer is one of the top five cancers among female. It is treated with surgery and chemotherapy. Besides the well-known tumor marker CA-125, the treatment response is monitored by radiological imaging. Computed tomography (CT) and magnetic resonance imaging are used to be the primary modalities. With the emergence of positron emission tomography (PET), the detection of residual or recurrence disease can be made more accurate. The fusion of PET/CT has higher sensitivity and specificity.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 15-18

scholarly journals Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Tetsuya Tsujikawa ◽  
Shizuka Yamada ◽  
Hidehiko Okazawa ◽  
Yoshio Yoshida
Keyword(s):  
Ovarian Cancer ◽  
Fdg Pet ◽  
Diagnostic Value ◽  
Mri Contrast ◽  
Diagnostic Potential ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Imaging Results ◽  
N Stage ◽  
Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) in ovarian cancer. Materials and methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95% CI 0.72–0.83) (p < 0.05). Accuracy for T status was 96.4% (95% CI 0.96–0.96) and 92.9% (95% CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95% CI 0.88–1.00) and 100% (95% CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95% CI 0.76–0.85) and 30.8% (95% CI 0.19–0.31) for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95% CI 0.57–0.91), 95.7% (95% CI 0.93–0.97) and 93.9% (95% CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95% CI 0.24–0.58), 96.6% (95% CI 0.94–0.98) and 90.8% (95% CI 0.87–0.94) for ceCT. Conclusions [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

scholarly journals Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity ◽  
Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

211 Presentation of a Flims study: The diagnostic value of PET/CT for primary ovarian cancer–aprospective study

2009 ◽  
Vol 7 (2) ◽  
pp. 54
Author(s):  
S. Risum ◽  
C. Hogdall ◽  
A. Loft ◽  
A.K. Berthelsen ◽  
E. Hogdall ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Value ◽  
Primary Ovarian Cancer ◽  
Pet Ct

Patient self-reporting of tolerability using PRO-CTCAE: A randomized double-blind placebo controlled phase II trial comparing gemcitabine in combination with adavosertib or placebo in women with platinum resistant epithelial ovarian cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5541-5541
Author(s):  
Ainhoa Madariaga ◽  
Sandra A. Mitchell ◽  
Tyler Pittman ◽  
Lisa Wang ◽  
Valerie Bowering ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Abdominal Pain ◽  
Objective Assessment ◽  
Area Under The Curve ◽  
Recurrent Ovarian Cancer ◽  
Median Number ◽  
Self Report ◽  
Double Blind ◽  
Patient Reported ◽  
Fatigue Severity

5541 Background: A 4 month improvement in OS was demonstrated when Wee1 inhibitor adavosertib (Ad) and gemcitabine (G; arm A) was compared to G and placebo (P; arm B) in a phase 2 trial in recurrent ovarian cancer (NCT02151292). The patient reported outcome version of the CTCAE (PRO-CTCAE) was used to capture self-report of the frequency, severity and/or interference (scored 0-4; higher scores indicating worse symptomatic adverse events [syAEs]). Methods: Ad/P was given orally on D1-2, D8-9, D15-16 with G D1, D8, D15 in a 28-day cycle. English speaking pts in 2 centres completed PRO-CTCAE items electronically in clinic at baseline, D1 and D15 of each cycle and off treatment. An exploratory objective was to characterize syAEs in the first 3 months of therapy. We calculated 12-week area under the curve (AUC12w) as a measure of syAE over time and incremental AUC12w (iAUC12w) for adjustment to baseline syAEs and compared arms A and B using an independent samples t-test. We assessed proportion of scores 3-4 at 6 time-points and compared them using Fisher’s Exact Test at each survey. Results: 51 pts were enrolled and completed ≥1 survey, 47 were evaluable for primary outcome (arm A: 28, B: 19). ECOG status was ≤1 in 44/47 pts. Median number of cycles of therapy were 5 (1-16) in arm A, and 2 (1-16) in B. Survey completion rates were high (arm A 93%, B 95%). Mean AUC12w fatigue severity (A 152 [standard error 9] vs B 112 [10]; p = 0.005) and interference (A 144 [11] vs 98 [15]; p = 0.018), diarrhea frequency (A 70 [12] vs B 33 [9]; p = 0.014), mucositis (A 23 [6] vs B 6 [3]; p = 0.012) and difficulty swallowing severity (A 10 [3] vs B 2 [2]; p = 0.023) were higher in arm A (any grade). There were no statistically significant between-arm differences in abdominal pain, bloating, nausea, vomiting and anxiety. The iAUC12w was significantly higher in arm A vs B for difficulty swallowing severity (A 10.1 [3] vs B -2.7 [4.7]; p = 0.02), mucositis severity (A 19.9 [6.6] vs B -3.1 [6.9]; p = 0.02) and fatigue severity (A 35.2 [8.2] vs B -3.1 [9.8]; p = 0.005). Proportions with high scores (3-4) were only significantly higher at C1D15 for fatigue severity in arm A (A 55% vs B 19%, p = 0.044). No significant differences were seen in other 3-4 scores per survey time. Conclusions: This is the first study evaluating pts self-reported toxicity with adavosertib in a randomized setting, allowing pts self-evaluation of toxicity in the context of improved PFS and OS. Greater fatigue, diarrhea, mucositis and difficulty swallowing were experienced by pts receiving adavosertib and gemcitabine, but score 3-4 reached significance on C1D15 fatigue only. No significant differences were detected in syAE profile for nausea, vomiting, abdominal pain, bloating and anxiety. This approach allows objective assessment of pts perception of toxicity with complex therapy. Clinical trial information: NCT02151292.

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