18FDG-PET/CT versus Contrast Enhanced CT in detection of mucinous ovarian cancer recurrence: comparative study

Objectives: to assess the added value of 18 FDG-PET/CT in detection of mucinous ovarian cancer (MOC) recurrence and its effect on patient management compared to contrast enhanced computerized tomography (CECT). Methods: All patients underwent 18 F-FDG PET/CT and CECT for detection of MOC recurrence. PET/CT and CT were interpreted separately and the significance of difference between them was evaluated. Results: The study included 59 patients, out of them 18 and 29 patients were proven to have local and distant recurrence respectively. PET/CT demonstrated greater sensitivity (SN) , positive predictive value (PPV), negative predictive value (NPV) and accuracy, but the same specificity (SP) in recurrence detection (97.9%, 90.2%, 87.5%, 89.8%, and 58.3%, vs. 85.1%, 88.9%, 50%, 79.7%, and 58.3%, respectively) and showed significantly higher sensitivity for detection of omento-peritoneal and LNs metastases (mets) (36 and 27 versus 22 and 18, p- 0.0001 and 0.004, respectively). Both modalities were comparable in identifying distant organ mets (p >0.05). PET/CT changed patient management in 25.4% of patients, Conclusion: 18 FDG-PET/CT showed higher SN and accuracy than CECT in MOC recurrence detection, mainly the omento-peritoneal and nodal deposits, which allow better guidance for proper therapy planning.