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.
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