HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sironi, S. Articles by Fazio, F. Search for Related Content PubMed PubMed Citation Articles by Sironi, S. Articles by Fazio, F.

Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings¹

¹ From the School of Medicine, University of Milano-Bicocca, Milan, Italy (S.S., C.M., B.Z., F.F.); Institute for Molecular Imaging and Physiology of the National Research Council of Italy, Milan (S.S., C.M., F.F.); and Departments of Nuclear Medicine (C.M., M.P., F.F.), Gynecology and Obstetrics (G.M., G.A., E.G., R.V.), Pathology (G.T.), and Radiology, University Vita-Salute (A.D.M.), Institute H S.Raffaele, Via Olgettina 60, 20132 Milan, Italy. Received November 7, 2003; revision requested January 15, 2004; revision received February 4; accepted March 2. Address correspondence to F.F. (e-mail: fazio.ferruccio@hsr.it).

View larger version (125K): [in a new window]   Figure 1a. Lymph node lesions in a patient with persistent papillary serous adenocarcinoma of the ovary. Transverse (a) unenhanced CT, (b) FDG PET, and (c) combined PET/CT images. In a, an enlarged paraaortic lymph node (arrow) appears as a rounded, well-defined soft-tissue mass. On the basis of these morphologic CT findings, differential diagnosis between reactive and neoplastic lymph node is difficult. In b, abnormal FDG uptake (arrow) is evident in the retroperitoneal region; the exact anatomic location of hyperaccumulation, however, remains uncertain. In c, the abnormal FDG uptake corresponds to the enlarged lymph node (white arrow), which suggests presence of tumor tissue. On this image, a small lymph node (black arrow) with increased FDG uptake can be seen behind the vena cava. Histologic analysis after surgical second-look confirmed the presence of viable tumor cells in both lymph nodes.

View larger version (94K): [in a new window]   Figure 1b. Lymph node lesions in a patient with persistent papillary serous adenocarcinoma of the ovary. Transverse (a) unenhanced CT, (b) FDG PET, and (c) combined PET/CT images. In a, an enlarged paraaortic lymph node (arrow) appears as a rounded, well-defined soft-tissue mass. On the basis of these morphologic CT findings, differential diagnosis between reactive and neoplastic lymph node is difficult. In b, abnormal FDG uptake (arrow) is evident in the retroperitoneal region; the exact anatomic location of hyperaccumulation, however, remains uncertain. In c, the abnormal FDG uptake corresponds to the enlarged lymph node (white arrow), which suggests presence of tumor tissue. On this image, a small lymph node (black arrow) with increased FDG uptake can be seen behind the vena cava. Histologic analysis after surgical second-look confirmed the presence of viable tumor cells in both lymph nodes.

View larger version (93K): [in a new window]   Figure 1c. Lymph node lesions in a patient with persistent papillary serous adenocarcinoma of the ovary. Transverse (a) unenhanced CT, (b) FDG PET, and (c) combined PET/CT images. In a, an enlarged paraaortic lymph node (arrow) appears as a rounded, well-defined soft-tissue mass. On the basis of these morphologic CT findings, differential diagnosis between reactive and neoplastic lymph node is difficult. In b, abnormal FDG uptake (arrow) is evident in the retroperitoneal region; the exact anatomic location of hyperaccumulation, however, remains uncertain. In c, the abnormal FDG uptake corresponds to the enlarged lymph node (white arrow), which suggests presence of tumor tissue. On this image, a small lymph node (black arrow) with increased FDG uptake can be seen behind the vena cava. Histologic analysis after surgical second-look confirmed the presence of viable tumor cells in both lymph nodes.

View larger version (85K): [in a new window]   Figure 2a. Peritoneal lesion in a patient with persistent endometroid carcinoma of the ovary. Transverse (a) unenhanced CT, (b) FDG PET, and (c) combined PET/CT images. In a, a peritoneal soft-tissue mass (arrow) with rounded margins is detectable. In b, a circumscribed area of intense focal FDG uptake (arrow) is seen in the lower portion of the abdominal cavity, presumably in the peritoneal region. In c, the relationship between the soft-tissue mass evident at CT and the area of abnormal FDG uptake evident at PET is well demonstrated (arrow); these imaging findings were suspicious for persistent disease. At histologic analysis after surgical second-look, the peritoneal lesion was found to be a solid tumor nodule adherent to adjacent bowel loops.

View larger version (78K): [in a new window]   Figure 2b. Peritoneal lesion in a patient with persistent endometroid carcinoma of the ovary. Transverse (a) unenhanced CT, (b) FDG PET, and (c) combined PET/CT images. In a, a peritoneal soft-tissue mass (arrow) with rounded margins is detectable. In b, a circumscribed area of intense focal FDG uptake (arrow) is seen in the lower portion of the abdominal cavity, presumably in the peritoneal region. In c, the relationship between the soft-tissue mass evident at CT and the area of abnormal FDG uptake evident at PET is well demonstrated (arrow); these imaging findings were suspicious for persistent disease. At histologic analysis after surgical second-look, the peritoneal lesion was found to be a solid tumor nodule adherent to adjacent bowel loops.

View larger version (74K): [in a new window]   Figure 2c. Peritoneal lesion in a patient with persistent endometroid carcinoma of the ovary. Transverse (a) unenhanced CT, (b) FDG PET, and (c) combined PET/CT images. In a, a peritoneal soft-tissue mass (arrow) with rounded margins is detectable. In b, a circumscribed area of intense focal FDG uptake (arrow) is seen in the lower portion of the abdominal cavity, presumably in the peritoneal region. In c, the relationship between the soft-tissue mass evident at CT and the area of abnormal FDG uptake evident at PET is well demonstrated (arrow); these imaging findings were suspicious for persistent disease. At histologic analysis after surgical second-look, the peritoneal lesion was found to be a solid tumor nodule adherent to adjacent bowel loops.

View larger version (100K): [in a new window]   Figure 3a. Pelvic lesion in a patient with persistent undifferentiated carcinoma of the ovary. Transverse (a) unenhanced CT, (b), FDG PET, and (c) combined PET/CT images. In a, a solid lesion (arrow), which apparently invades the rectal wall, is shown. In b, an area of intense uptake (arrow) is evident in the pararectal region. In c, the abnormal focal FDG uptake (arrow) corresponds to the solid mass shown on a; therefore, findings at combined PET/CT are strongly suggestive of persistent malignant tissue in the pelvis. At histologic analysis after surgical second-look, the lesion proved to be a gross tumor nodule widely infiltrating the rectal wall.

View larger version (88K): [in a new window]   Figure 3b. Pelvic lesion in a patient with persistent undifferentiated carcinoma of the ovary. Transverse (a) unenhanced CT, (b), FDG PET, and (c) combined PET/CT images. In a, a solid lesion (arrow), which apparently invades the rectal wall, is shown. In b, an area of intense uptake (arrow) is evident in the pararectal region. In c, the abnormal focal FDG uptake (arrow) corresponds to the solid mass shown on a; therefore, findings at combined PET/CT are strongly suggestive of persistent malignant tissue in the pelvis. At histologic analysis after surgical second-look, the lesion proved to be a gross tumor nodule widely infiltrating the rectal wall.

View larger version (91K): [in a new window]   Figure 3c. Pelvic lesion in a patient with persistent undifferentiated carcinoma of the ovary. Transverse (a) unenhanced CT, (b), FDG PET, and (c) combined PET/CT images. In a, a solid lesion (arrow), which apparently invades the rectal wall, is shown. In b, an area of intense uptake (arrow) is evident in the pararectal region. In c, the abnormal focal FDG uptake (arrow) corresponds to the solid mass shown on a; therefore, findings at combined PET/CT are strongly suggestive of persistent malignant tissue in the pelvis. At histologic analysis after surgical second-look, the lesion proved to be a gross tumor nodule widely infiltrating the rectal wall.