CA-125 Correlates with Metastatic Status at [18F]FDG PET/CT in Patients with Relapsed Ovarian Cancer
Keywords:
PET, Positron Emission Tomography, Ovarian Cancer, CA-125Abstract
Background: ovarian cancer (OC) relapse can be diagnosed with the evaluation of tumor markers and 18Ffluorodoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) findings. The aim of our study was to assess the correlation between CA-125 and [18F]FDG PET/CT findings in terms of metastatic disease in patients with OC relapse. Material and Methods: 68 PET/CT scans positive for OC relapse were analyzed qualitatively and semiquantitatively by measuring the maximum and mean standardized uptake value body weight max (SUVmax, SUVmean), SUV lean body mass (SUVlbm), SUV body surface area (SUVbsa), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of hypermetabolic lesions. These parameters and CA-125 were correlated with the metastatic status of patients. Results: correlation of presence of distant metastases with MTV (p value <0.001), TLG (p value <0.001) and CA-125 (p value 0.010) were reported; no correlation with SUVmax, SUVmean, SUVlbm and SUVbsa were underlined. Moreover, correlation between the type of distant metastases (nodal or extranodal) with MTV (p value 0.021), TLG (p value 0.044) and CA-125 (p value 0.037) were underlined; no correlation with SUVmax, SUVmean, SUVlbm and SUVbsa were reported. Receiving operating characteristic (ROC) curve analysis revealed acceptable performances in both cases. Conclusions: Correlation between volumetric [18F]FDG PET/CT parameters and CA-125 with the metastatic status was reported.
References
Marzola MC, Chondrogiannis S, Rubello D. Fludeoxyglucose F 18 PET/CT Assessment of Ovarian Cancer. PET Clin. 2018; 13(2): 179–
https://doi.org/10.1016/j.cpet.2017.11.005
Colombo N, Sessa C, Bois Adu, et al. ESMO–ESGO Ovarian Cancer Consensus Conference Working Group. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Int J Gynecol Cancer. 2019 [Epub ahead of print]. https://doi.org/10.1136/ijgc-2019-000308
Bellini, P., Albano, D., Dondi, F. et al. Clinical Meaning of 18F-FDG PET/CT Incidental Gynecological Uptake: An 8-Year Retrospective Analysis. Indian J Gynecol Oncolog 19, 99 (2021). https://doi.org/10.1007/s40944-021-00596-8
Signorelli M, Guerra L, Pirovano C, et al. Detection of nodal metastases by 18F-FDG PET/CT in apparent early stage ovarian cancer: a prospective study. Gynecol Oncol. 2013; 131(2): 395–399. https://doi.org/10.1016/j.ygyno.2013.08.022
Gu P, Pan LL, Wu SQ, et al. CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and
meta-analysis. Eur J Radiol. 2009; 71(1): 164–174’. https://doi.org/10.1016/j.ejrad.2008.02.019
Kim TH, Kim J, Kang YK, et al. Identification of Metabolic Biomarkers Using Serial F-FDG PET/CT for Prediction of Recurrence in Advanced Epithelial Ovarian Cancer. Transl Oncol. 2017; 10(3): 297–303. https://doi.org/10.1016/j.tranon.2017.02.001
Antunovic L, Cimitan M, Borsatti E, et al. Revisiting the clinical value of 18F-FDG PET/CT in detection of recurrent epithelial ovarian carcinomas: correlation with histology, serum CA-125 assay, and conventional radiological modalities. Clin Nucl Med. 2012; 37(8): e184–e188. https://doi.org/10.1097/rlu.0b013e31825b2583
Goonewardene TI, Hall MR, Rustin GJS. Management of asymptomatic patients on follow-up for ovarian cancer with rising CA-125
concentrations. Lancet Oncol. 2007; 8(9): 813– 821. https://doi.org/10.1016/s1470-2045(07)70273-5
Rustin GJ, Nelstrop AE, McClean P, et al. Defining response of ovarian carcinoma to initial chemotherapy according to serum CA 125. J
Clin Oncol. 1996; 14(5): 1545–1551. https://doi.org/10.1200/jco.1996.14.5.1545
Santillan A, Garg R, Zahurak ML, et al. Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the
normal range. J Clin Oncol. 2005; 23(36): 9338–9343. https://doi.org/10.1200/jco.2005.02.2582
Ghosh J, Thulkar S, Kumar R, et al. Role of FDG PET-CT in asymptomatic epithelial ovarian cancer with rising serum CA-125: a pilot
study. Natl Med J India. 2013; 26(6): 327–331.
Dondi F, Albano D, Bertagna F, Giubbini R. [18F]FDG PET/CT and CA-125 in the evaluation of ovarian cancer relapse or persistence: is there any correlation? Nucl Med Rev Cent East Eur. 2022;25(2):78-84. https://doi.org/10.5603/nmr.a2022.0018
Boellaard R, Delgado-Bolton R, Oyen WJG, et al. European Association of Nuclear Medicine (EANM). FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015; 42(2): 328–354.
Limei Z, Yong C, Yan Xu, et al. Accuracy of positron emission tomography/ computed tomography in the diagnosis and restaging for
recurrent ovarian cancer: a meta-analysis. Int J Gynecol Cancer. 2013; 23(4): 598–607. https://doi.org/10.1097/igc.0b013e31828a183c
Ebina Y, Watari H, Kaneuchi M, et al. Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian
cancer. Eur J Nucl Med Mol Imaging. 2014; 41(3): 446–451.
Soussan M, Wartski M, Cherel P, et al. Impact of FDG PET-CT imaging on the decision making in the biologic suspicion of ovarian carcinoma recurrence. Gynecol Oncol. 2008; 108(1): 160–165. https://doi.org/10.1016/j.ygyno.2007.07.082
Palomar A, Nanni C, Castellucci P, et al. Value of FDG PET/CT in patients with treated ovarian cancer and raised CA125 serum levels. Mol
Imaging Biol. 2012; 14(1): 123–129. https://doi.org/10.1007/s11307-010-0468-9
Menzel C, Döbert N, Hamscho N, et al. The influence of CA 125 and CEA levels on the results of (18)F-deoxyglucose positron emission tomography in suspected recurrence of epithelial ovarian cancer. Strahlenther Onkol.20 04; 180(8): 497–501. https://doi.org/10.1007/s00066-004-1208-3
Thrall MM, DeLoia JA, Gallion H, et al. Clinical use of combined positron emission tomography and computed tomography (FDG-PET/CT) in
recurrent ovarian cancer. Gynecol Oncol. 2007;105(1): 17–22. https://doi.org/10.1016/j.ygyno.2006.10.060
Evangelista L, Palma MD, Gregianin M, et al. Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission
tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer.
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