The clinical value of 18F-FDG SPECT imaging in detecting recurrence of the patients with postoperative epithelial ovarian carcinoma

Objective: To evaluate the diagnostic efficacy of 18F-fluorodeoxyglucose (FDG) SPECT imaging for detecting recurrence in postoperative epithelial ovarian carcinoma. Methods: This study included 33 patients after optimal cyto-reductive surgery and sufficient chemotherapy, with clinical remission more than 6 months, 20 patients after second exploration or cyto-reductive surgery were evaluated with pathologic study, and 13 patients not operated were evaluated with other methods. The raw data with attenuation correction (AC) and non attenuation correction (NAC) were reconstructed iteratively, and the ratios of lesion to Background (L/B) were calculated with the region of interest (ROI) method. The CT, B-ultrasonography and CA125 level in plasma were also measured. Results: Lesions with high 18F-FDG uptake were detected in 24 patients and false 18F-FDG uptake in 3 patients. The L/B ratios of AC and NAC images were 4.9±4.3 and 4.2±4.0, respectively. 9 patients showed no abnormal uptake in 18F-FDG SPECT images and 4 patients were false negative. The sensitivity, specificity, accuracy, positive and negative predictive value of 18F-FDG SPECT imaging were 84.0%, 62.5%, 78.8%, 87.5% and 55.6%, respectively. There were significant differences in the accuracy of 18F-FDG SPECT imaging with CT and B-ultrasonography. Conclusion: 18F-FDG SPECT imaging is useful for diagnosis of recurrence in epithelial ovarian carcinoma and can give additional information other than CT and B-ultrasonography. (authors)