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

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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