الفهرس 
Anatomy of the OvaryOnly 14 pages are availabe for public view
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Abstract
Background: 18F-Flurodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/) is increasingly being used in staging of malignant ovarian tumors as well as evaluation of the treatment efficacy. In literature extensive data have shown that 18F-FDG is valuable in determining prognosis of preoperative ovarian cancer. However, there are relatively fewer studies in terms of PET/CT’s utility in predicting prognosis of recurrent ovarian cancer.
Aim of the Study: To evaluate the role of 18F-Flurodeoxyglucose positron emission tomography/ computed tomography in prediction of progression of peritoneal metastases after initial surgical treatment of malignant ovarian tumors.
Patients and Methods: Type of Study: Descriptive, Retrospective Cohort study. Study Setting: The study was conducted at Ain Shams University Hospitals and a private center for July 2018 to April 2021. Study Population: Twenty-four patients with surgically removed ovarian tumors.
Results: There was a statistically negative correlation between PFS in relation to SUVmax. Kaplan Mayer analysis for PFS in relation to SUVmax showed a statistically significant relation between two groups using the median value of 7.4 that was calculated in our study with p-value= 0.013. There was also a statistically significant negative correlation between overall survival and SUVmax of the peritoneal lesions with p-value= 0.026. There was significant correlation between progression-free survival and patients with associated lymph node involvement. Our study found that patient with peritoneal metastasis without lymph node involvement had longer progression free survival than patients with both peritoneal and lymph node involvement with p-value= 0.043. However, when evaluating the patients regarding overall response to chemotherapy, our study found no statistically significant difference between responders and non-responders regarding initial PET/CT SUVmax as a numerical value or other anatomical parameters such as localized vs diffuse peritoneal dissemination.
Conclusion: Various papers that have studied the potential ability of 18F-FDG PET/CT Maximum Standardized Uptake Values (SUVmax) to predict prognosis of recurrent ovarian cancer and peritoneal metastasis showed promising results. In our study, while no cut off value was found to predict the response to therapy, 18F-FDG PET/CT SUVmax of peritoneal metastasis had a prognostic value regarding progression-free survival and overall survival. Also, lymph node involvement negatively affected patient prognosis. Subsequent PET-CT had significant SUVmax percentage change between responders and non-responders, making subsequent PET/CT a useful tool in tumor response assessment. Currently there are limited prospective studies due to the lack of use of PET/CT as the standard method for response assessment. Hence, recommendations for further evaluation include prospective follow up, longer follow up duration, larger sample size, and stratification of patient population according to treatment modality, stage of treatment, and pathological type of the ovarian cancer.