Report from SNM: PET/CT excels in management of recurring ovarian cancer

The largest multicenter prospective trial of PET/CT ever conducted in Australia has found that it can identify which women with a history of ovarian cancer are susceptible to recurrence of the disease. The hybrid imaging modality can detect more sites of disease than CT or ultrasound and changes patient management in many cases.

Dr. Michael J. Fulham, chief of PET and nuclear medicine at the Royal Prince Alfred Hospital in Sydney, and colleagues assessed 90 women with a mean age of 59 years, previous history of epithelial ovarian carcinoma, and suspected recurrence based on CA 125 levels. Patients underwent PET/CT examination, and their referring physicians were asked to assess PET/CT's impact on patient management.

The investigators found at least 168 additional sites of mostly nodal or peritoneal lesions not identified by either CT or ultrasound in almost two-thirds of these patients. They found that patients with additional disease sites detected by PET/CT were more likely to have recurrence within a year. Thirty-four referring physicians reported that PET/CT had affected management in 59% of these patients.

Findings suggest that replacing CT of the abdomen and pelvis with PET/CT would reduce costs and provide better answers for patients and referring doctors, Fulham said. He presented results Monday at the 2007 SNM meeting.

PET was introduced in Australia in the early 1990s, with little financial support from the Commonwealth government. When officials reviewed results from the first PET/CT trial in 2000, they concluded that there were not enough patients to prove the efficacy of hybrid imaging but agreed to support further data collection. The additional data from patients recruited between December 2003 and February 2006 helped researchers to arrive at the conclusion that PET/CT should be the imaging technique of choice for suspected recurrence, Fulham said.

Ovarian cancer is the principal cause of death in women with gynecological cancers. More than 22,000 new cases and about 15,000 deaths attributed to this condition are expected this year. The next stage for the investigative team will be to identify patients with residual disease after initial diagnosis and treatment. Earlier diagnosis should yield better outcomes, he said.

For more information from the Diagnostic Imaging archives:

Imaging keeps major role in uterine cavity

PET/CT finds footing in breast, cervical, and ovarian carcinoma

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