Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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Role of $^{18}F$-fluorodeoxyglucose PET/CT in Recurrent Ovary Cancer

재발 난소암의 진단에서의 $^{18}F$-fluorodeoxyglucose PET/CT의 유용성: Enhanced CT와 Tumor Marker CA 125와의 비교

  • O, Joo-Hyun (Department of Radiology, The Catholic University of Korea) ;
  • Yoo, Ie-Ryung (Department of Radiology, The Catholic University of Korea) ;
  • Choi, Woo-Hee (Department of Radiology, The Catholic University of Korea) ;
  • Lee, Won-Hyoung (Department of Radiology, The Catholic University of Korea) ;
  • Kim, Sung-Hoon (Department of Radiology, The Catholic University of Korea) ;
  • Chung, Soo-Kyo (Department of Radiology, The Catholic University of Korea)
  • 오주현 (가톨릭 대학교 영상의학과학교실) ;
  • 유이령 (가톨릭 대학교 영상의학과학교실) ;
  • 최우희 (가톨릭 대학교 영상의학과학교실) ;
  • 이원형 (가톨릭 대학교 영상의학과학교실) ;
  • 김성훈 (가톨릭 대학교 영상의학과학교실) ;
  • 정수교 (가톨릭 대학교 영상의학과학교실)
  • Published : 2008.06.30
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Abstract

Purpose: To date, anatomical imaging modalities of the pelvis and tumor markers have been the mainstay of surveillance for recurrent ovary cancer. This study aimed to assess the role of $^{18}F$-FDG PET/CT in evaluation of ovary cancer recurrences, especially in comparison with enhanced a and tumor marker CA 125. Materials and methods: 73 patients who had PET/CT scan for restaging of confirmed ovary cancer, and additional imaging with enhanced a of the pelvis within one month were included. CA 125 level was available in all patients. From the PET/CT images, maximum standard uptake values (SUVmax) of suspected recurrence sites were recorded. Confirmation was available through re-operation or biopsy in 26 cases, and clinical assessment with series of follow-up images in 47. Results: PET/CT had 93% sensitivity and 88% specificity for detecting recurrent ovary cancer. Enhanced a of pelvis had sensitivity and specificity of 83% and 88%, and CA 125 50% and 95%. Conclusion: PET/CT has higher sensitivity for detecting recurrent ovary cancer compared to enhanced a though the differences were not significant. PET/CT has significantly higher sensitivity than CA 125. However, the three tests all agreed in only 43% of the recurrence cases, and recurrence should be suspected when any of the tests, especially PET/CT, show positive findings.

목적: 현재까지 난소암의 재발을 평가하는데 해부학적 영상 검사와 tumor marker들이 주를 이루고 있다. 저자들은 재발 난소암의 진단에서 CT, 그리고 tumor marker CA 125와 비교하여 $^{18}F$-FDG PET/CT의 유용성을 알아보고자 하였다. 대상 및 방법: 조직학적으로 확진 된 난소암 환자 중 재발 평가를 위하여 PET/CT를 시행하고 한달 이내로 pelvis CT 검사를 시행한 환자 73명을 대상으로 하였다. Tumor marker CA 125은 모두에서 측정하였다. PET/CT 영상에서 의심되는 부위의 maximum SUV를 기록하였다. 26명은 수술 또는 생검을 통해 확진되었고, 나머지 47명은 임상 소견과 추적 영상 검사를 통하여 진단하였다. 결과: 난소암의 재발을 진단하는데 PET/CT의 예민도는 93%였고, 특이도는 88%였다. Enhanced CT의 예민도는 83%, 특이도는 88%였다. Tumor marker CA 125의 예민도와 특이도는 각각 50%와 95%였다. 결론: 재발 난소암의 진단에서 FDG PET/CT의 예민도가 CT보다 좋았으나 통계학적으로 의미 있는 차이는 아니였고, 특이도는 PET/CT 와 CT가 비슷하였다. Tumor marker CA 125보다는 PET/CT의 예민도가 월등히 높았다. 하지만 재발 환자에서 위의 세 검사의 일치도는 43%로 낮은 편으로, 난소암 환자의 경과 관찰 중, 특히 PET/CT 영상에서, 양성 소견이 보이면 재발의 가능성이 높다.

Keywords

References

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