PET-BT Use in Evaluation of Metastatic Ovarian Cancers

Many patients with ovarian cancer are at high risk of recurrence especially in the 2 years following fist-line therapy. CA 125 serum levels measurement associated to computed tomography (BT), ultrasound (US) and magnetic resonance imaging (MRI) are currently used during follow-up to detect recurrent disease. However, CT is the most effective and useful tool at all of these conventional methods. Unfortunately, in a relevant percentage of cases all of these traditional imaging techniques provide a significant number of doubtful/equivocal results or turn out negative even in presence of elevated Ca 125 levels. Noninvasive diagnosis of early recurrence of ovarian cancer is challenging due to the small size of peritoneal metastases. Occasionally small-volume disease may not be evident at anatomic imaging in patients with high CA 125 levels. Positron emission tomography (PET) can help of these patients to identify patients with recurrent tumor. Nevertheless, lesion localization for possible surgery is difficult with PET alone. Combined functional-anatomic imaging with fused PET and computed tomographic (CT) scans is practicable and may upgrade disease detection by increasing radiologic sensitivity and specificity.