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Asymptomatic Adnexal Masses: Correlation of FDG PET and Histopathologic Findings¹

¹ From the Departments of Nuclear Medicine (S.F., J.K., S.N.R.), Obstetrics and Gynecology (D.G., R.K.), and Radiology (K.N., A.R., H.J.B.), University of Ulm, Steinhövelstrasse 9, 89075 Ulm, Germany. From the 1999 RSNA scientific assembly. Received November 24, 2000; revision requested January 10, 2001; revision received September 11; accepted October 10. Address correspondence to S.F. (e-mail: sabine.fenchel@medizin.uni-ulm.de).

View larger version (148K): [in a new window]   Figure 1. A, Transverse and B, sagittal FDG PET images of stage pT3c ovarian adenocarcinoma. The intense FDG uptake of the tumor bulk (arrowheads) and the peritoneal metastases (large arrows) are characteristic of malignancy. The small arrow demonstrates activity in the urinary bladder. C, Transvaginal sonogram shows large irregulary solid patterns (arrowhead) with irregulary cystic parts (arrow). D, Corresponding sagittal T1-weighted two-dimensional gadolinium-enhanced MR image (72.5/4.1; flip angle, 70°) shows the tumor bulk (arrowhead) and the peritoneal metastases (arrow).

View larger version (68K): [in a new window]   Figure 2. A, Coronal and B, transverse FDG PET images of an inflammatory tumor (salpingitis) (arrows) in the left lower pelvis demonstrate the typical intense FDG metabolism of inflammations.

View larger version (49K): [in a new window]   Figure 3. A, Coronal and B, transverse FDG PET images of a cystic endometrioma (arrows). Like most endometriomas, the cystic tumor presents as a photopenic defect without elevated FDG uptake in the interior of the cyst or in the tumor wall. The tumor is surrounded by gastrointestinal activity (arrowheads), which demonstrates the typical curved nonfocal configuration of physiologic gastrointestinal activity. C, Corresponding transverse T2-weighted turbo spin-echo MR image (2,800/138 msec; flip angle, 180°) of the cystic endometrioma (arrow). D, Transvaginal sonogram shows a single-chambered cyst with multiple linear echos (according to Kawai et al, score 6) and a papillary wall structure (according to DePriest et al, score 3) (arrow).