Peritoneal Carcinomatosis in Patients With Ovarian Cancer Enhanced CT Versus 18F-FDG PET/CT

Abstract

Purpose: The study aimed to evaluate the efficacy of PET/CT in detecting peritoneal carcinomatosis in patients with ovarian cancer and to compare the diagnostic accuracy of FDG PET/CT with that of enhanced abdominal CT. Methods: The medical records of 46 consecutive patients with ovarian cancer were reviewed, and the presence of peritoneal tumor on 18F-FDG PET/CT and enhanced abdominal CT scans was also assessed. Imaging results were compared with the pathologic findings obtained by surgery. Results: Pathologic results were positive for peritoneal carcinomatosis in 26 patients and negative in 20 patients. PET/CT correctly detected 25 of 26 patients with peritoneal carcinomatosis and enhanced abdominal CT correctly detected 23 of 26 patients. Sensitivity and specificity for the diagnosis of peritoneal carcinomatosis were 96.2% and 90%, respectively, for PET/CT and 88.5% and 65%, respectively, for enhanced abdominal CT. The accuracy of PET/CT was statistically higher than that of enhanced abdominal CT (93.5% vs 78.3%, P = 0.039). Four distinctly abnormal PET/CT findings of single nodular, multiple nodular, diffuse, and mixed FDG uptakes were identified and corresponded to pathologic findings. Conclusions: 18F-FDG PET/CT imaging is efficient in the diagnosis of peritoneal carcinomatosis and its performance is superior to that of enhanced abdominal CT. KeyWords: ovarian cancer, peritoneal carcinomatosis, PET/CT, enhanced CT, 18F-FDG