Predictive value of PET-CT imaging versus AGO-scoring in patients planned for cytoreductive surgery in recurrent ovarian cancer

Objective: To assess the predictive value of PET-CT imaging in comparison to AGO-scoring in patients planned for cytoreductive surgery in recurrent ovarian cancer.

Materials and Methods: 33 patients who had received a PET-CT for suspicion of recurrent ovarian cancer between 12/2003 and 08/2007 were included in the retrospective analysis. Indication for PET-CT was based on blood tumor markers Ca 125 or Ca 72–4 and clinical symptoms. Scanning was performed on a Philips Gemini System covering the body from the neck to the thighs one hour after administration of 200 MBq fluorodesoxyglucose. PET-CT, surgery and the patient records were reviewed to analyze the predictive value of PET-CT in comparison to an AGO-scoring system based on clinical parameters with regard to the prediction of full resectability of abdominal tumor spread.

Results: The statistical analysis of this data showed a sensitivity of 73% (95% C. I., 39–94%) and specificity of 80% (95% C. I., 29–97%) for AGO scoring with a positive predictive value of 89% and a negative predictive value of 57%. PET-CT achieved a sensitivity of 100% (95% C. I., 72–100%) and specificity of 60% (95% C. I. 15–94%). Further analysis of the data of operated patients with concordant PET-CT and AGO-score (12/16) showed a very good prediction of full resectability with a sensitivity of 100% (95% C.I., 63–100%), specificity of 75% (95% C.I., 20–96%).

Conclusion: PET-CT and the AGO-score offer good tools to determine patients for full resectability in recurrent ovarian cancer. PET-CT has a higher negative and the AGO score a higher positive predictive value, and the combination of both improves the diagnostic accuracy.

Operation - Ovarialkarzinom - PET-CT - Rezidiv