Differential Diagnosis of Borderline Ovarian Tumors from Stage I Malignant Ovarian Tumors using FDG PET/CT
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ORIGINAL ARTICLE
Differential Diagnosis of Borderline Ovarian Tumors from Stage I Malignant Ovarian Tumors using FDG PET/CT Chulhan Kim & Hyun Hoon Chung & So Won Oh & Keon Wook Kang & June-Key Chung & Dong Soo Lee
Received: 7 November 2012 / Revised: 24 February 2013 / Accepted: 5 March 2013 / Published online: 4 April 2013 # Korean Society of Nuclear Medicine 2013
Abstract Purpose Borderline ovarian tumors (BOTs) are more common in young women of reproductive age, and exhibit a better prognosis than malignant ovarian tumors (MOTs). Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were compared in their ability to differentiate BOTs from stage I MOTs. Methods Among 173 patients who had preoperative FDG PET/CT due to ovarian neoplasms between November 2006 and March 2009, there were 13 patients with BOTs or stage I MOTs. For differential diagnosis of the two tumors, cancer antigen-125 (CA-125) level, the longest diameter of tumors, metabolic indices including maximum standardized uptake value (SUVmax), and volumetric indices including metabolic tumor volume (MTV) were compared, respectively. Results The BOT group (n=7) was comprised of five mucinous and two serous tumors, and the MOT group (n=6) C. Kim : S. W. Oh : K. W. Kang : J.-K. Chung : D. S. Lee Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea H. H. Chung Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea S. W. Oh (*) Department of Nuclear Medicine, Seoul National University Boramae Medical Center, 20 Boramae-Ro-5-Gil, Dongjak-Gu, Seoul 156-707 Seoul, Republic of Korea e-mail: [email protected] D. S. Lee Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea C. Kim Department of Nuclear Medicine, Korea University Ansan Hospital, Ansan, Korea
was comprised of three endometrioid, two clear cell and one mucinous tumors. Among the comparisons between two groups, SUVmax of the BOT group was significantly lower than that of the MOT group (2.9±1.5 vs. 6.6±2.9, p=0. 0223); otherwise, no significant difference was found in age, CA-125, diameter, or MTV. By receiver-operating characteristic curve analysis, SUVmax of 3.7 was the best cutoff value to differentiate BOTs from stage I MOTs, with a sensitivity of 83.3 % and specificity of 85.7, and the area under curve of 0.893 (p=0.0001, 95 % CI: 0.601∼0.993). Conclusions We demonstrated that SUVmax could distinguish BOTs from stage I MOTs, with a high sensitivity and specificity. Metabolic indices determined by FDG PET/CT were more suitable than volumetric indices for differential diagnosis of the two tumors. Keywords Borderline ovarian tumor . Stage I malignant ovarian tumor . FDG PET/CT . Standard uptake value (SUV) . Metabolic tumor volume (MTV)
Introduction Borderline ovarian tumors (BOTs) were distinctly categorized by the International Federation of Gynecology and Obstetrics (FIGO)
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