PET for Ovarian cancer – pro

The test is investigational, in the sense that experts agree that it needs to be better studied for staging, reataging and surveillacne of ovarian cancer, but it is not routinely recommended by guidelines. Many studies suggest that PET is a more sensitive modality than CT . However, the most recent guideline by Prefontainee et al in 2010 says: “PET is not recommended for staging of ovarian cancer.” It comes to the same conclusion for its use for recurrence. PET is not recommended for detecting recurrence or restaging patients not being considered for surgery. A recommendation cannot be made for or against the use of PET for patients being considered for secondary cytoreduction because of insufficient evidence.” 1

For evaluating possible recurrences, PET is graded 7/9 by AACR. CAT is 9. It states that if available PET can substitute for CT (but not that it is preferred or better). 2

NCCN only recommends it for initital staging if CT or MRI is indeterminate.

For evaluating possible recurrences, PET is graded 7/9 by AACR’CAT is 9. It states that if available PET can substitute for CT (but not that it is preferred or better). However, in the situation of rising CA-125 levels, PET is more accepted. NCCN lists PET in this situation as a Grade 2b recommendation.

1.Prefontaine M, Walker-Dilks C. PET imaging in ovarian cancer: recommendations. Toronto (ON): Cancer Care Ontario (CCO); 2009 Jan 19. 17 p. (Recommendation report – PET; no. 7). [46 references]

2.Agency for Healthcare Research and Quality (AHRQ). Positron emission tomography for nine cancers (bladder, brain, cervical, kidney, ovarian, pancreatic, prostate, small cell lung, testicular). Prepared by the University of Alberta Evidence-Based Practice Center for the Agency for Healthcare Research and Quality (AHRQ). Rockville, MD: AHRQ; 2008.

3.Javitt MC, Fleischer AC, Andreotti RF, Angtuaco TL, Horrow MM, Lee SI, Lev-Toaff AS, Scoutt LM, Zelop C, Expert Panel on Women’s Imaging. Staging and follow-up of ovarian cancer. [online publication]. Reston (VA): American College of Radiology (ACR); 2007. 5 p. [38 references]

4. NCCN, OV-1, 2015

Risum S, Hogdall C, Loft A, et al. The diagnostic value of PET/CT for primary ovarian cancer – A prospective study. Gynecol Oncol 2007;105:145-9.

Maurie Markman Use of Positron Emission Tomography Scans in Ovarian Cancer: A Diagnostic Technique in Search of an Indication Journal of Clinical Oncology, Vol 23, No 30 (October 20), 2005: pp. 7385-7387

Norbert Avril, Stefanie Sassen, Barbara Schmalfeldt, Joerg Naehrig, Stephan Rutke, Wolfgang A. Weber, Martin Werner, Henner Graeff, Markus Schwaiger, and Walther Kuhn Prediction of Response to Neoadjuvant Chemotherapy by Sequential F-18-Fluorodeoxyglucose Positron Emission Tomography in Patients With Advanced-Stage Ovarian Cancer JCO 2005 23: 7445-7453

Y. Hama, Positron emission tomography with 18F-fluoro-2-deoxyglucose for the detection of recurrent ovarian cancer. Int J Clin Oncol. 2006 Jun;11(3):250-1.

Rusu Daniela, Carlier Thomas, Colombié Mathilde, Goulon Dorothée, Fleury Vincent, Rousseau Nicolas, Berton-Rigaud Dominique, Jaffre Isabelle, Kraeber-Bodéré Françoise, Campion Loic, Rousseau Caroline linical and Survival Impact of FDG PET in Patients with Suspicion of Recurrent Ovarian Cancer: A 6-Year Follow-Up rontiers in Medicine VOLUME=2 YEAR=2015 p. 46

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