Metastatik Over Kanserlerini Değerlendirmede PET / BT

Pek çok over Ca’lı hasta birinci basamak tedaviyi takiben 2 yıl içerisinde rekürrens açısından yüksek risk altındadır. Günümüzde rekürren hastalığın tespitinde CA125 serum düzeyleri, bilgisayarlı tomografi (BT), manyetik rezonans görüntüleme (MRI) ve ultrasonografi (USG) kullanılmaktadır. Ancak bu görüntüleme metotları arasında BT en etkili ve kullanışlı olanıdır. Ancak vakaların önemli bir kısmında bu görüntüleme teknikleri kesin sonuç veremez. Bazı hallerde şüpheli pozitif yada belirsiz sonuçlar vermekte bazen ise CA 125 seviyeleri yüksek olduğu halde sonuçlar negatif gelmektedir. Over kanserinin erken rekürrensine ait periton metastazlarını çok küçük boyutlarda olduğunda noninvaziv tanı zorlaşmaktadır. Bazı durumlarda küçük çaplı hastalık CA 125 düzeyleri yüksek hastalarda anatomik görüntülerde saptanamamaktadır. Pozitron emisyon tomografisi (PET) bu tip hasta grubundaki rekürren hastalığı saptamada faydalı olabilir. Buna karşın pozitif PET sonuçları cerrahi açıdan lokalizasyonu belirlemekte yetersiz kalmaktadır. Bu bakımdan fonksiyonel ve anatomik görüntülemenin beraber kullanıldığı PET-BT rekürren hastalığı saptamada yüksek sensitivite ve spesifiteye sahip kullanışlı bir görüntüleme tekniğidir

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  • Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1999, CA Cancer J Clin 1999;49:8-31.
  • Fiorca JV, Roberts WS. Screening for ovarian cancer. Cancer Control 1996;3(2):120-129.
  • Conti PS, Lilien DL, Hawley K, et al. PET and FDG in oncology: a clinical update. Nucl Med Biol 1996;23(6):717-35.
  • Strauss LG, Conti PS. The applications of PET in clinical oncology. J Nucl Med 1991;32(4):623-48.
  • Cannistra SA. Cancer of the ovary. N Engl J Med 1993;329(21):1550-9.
  • Markman M, Bookman MA. Second-line treatment of ovarian cancer. Oncologist 2000;5(1):26-35.
  • Morrow CP, Curtin JP, Townsend DE. Tumors of the ovary: classification of the adnexal mass. In: Synopsis of gynecologic oncology. 4th Ed. New York: Churchill Livingstone, 1993:265.
  • Jacobs I, Bast RC Jr. The CA 125 tumor-associated antigen: A review of the literature. Hum Reprod 1989;4(1):1-12.
  • Niloff JM, Bast RC Jr, Schaetzl EM, et al. Predictive value of CA 125 antigen levels in second-look procedures for ovarian cancer. Am J Obstet Gynecol 1985;151(7):981-6.
  • Patsner B, Orr JW Jr, Mann WJ Jr, et al. Does serum CA-125 level prior to second-look laparotomy for invasive ovarian adenocarcinoma predict size of residual disease? Gynecol Oncol 1990;38(3):373-6.
  • Method MW, Serafini AN, Averette HE, et al. The role of radioimmunoscintigraphy and computed tomography scan prior to reassessment laparotomy of patients with ovarian carcinoma. A preliminary report. Cancer 1996;77(11):2286-93.
  • Ferrozi F, Bova D, De Chiara F, et al. Thin-section CT follow-up of metastatic ovarian carcinoma correlation with levels of CA-125 marker and clinical history. Clin Imag 1998;22(5):364-70.
  • Uysal U, Kostakoğlu L, Elahi N, et al. Can bone scintigraphy detect additional metastatic sites unrevealed by CT in patients with recurrent ovarian carcinoma? Radiat Med 1997;15(1):55-58.
  • Giunta S, Venturo I, Mottolese M, et al. Noninvasive monitoring of ovarian cancer: improved results using CT with intraperitoneal contrast combined with immunocytology. Gynecol Oncol 1994;53(1):103-8.
  • Garcia–Velloso MJ, Jurado M, Ceamanos C, et al. Diagnostic accuracy of FDG PET in the follow-up of palatinum-sensitive epithelial ovarian carcinoma. Eur J Nucl Med Mol Imaging 2007;34(9):1396-405.
  • Kubik-Huch RA, Dorffler W, von Schulthess GK, et al. Value of 18-FDG PET, CT and magnetic resonance imaging in diagnosis primary and recurrent ovarian carcinoma. Eur Radiol 2000; 10(5):761-7.
  • See HT, Kavanagh JJ, Hu W, Bast RC. Targeted therapy for epithelial ovarian cancer: current status are future prospects. Int J Gynecol Cancer 2003;13(6):701-34.
  • Henkin RE, Bova D, Dillehay GL, et al. Nuclear Medicine 2nd edition, 1st volume, Pennsylvania: Mosby Elsevier; 2006: 257-85.
  • Kapoor V, McCook BM, Torok FS. An Introduction to PET-CT Imaging. Radiographics 2004;24(2):523-43
  • Berry JD, Cook GJR. PET in oncology. British Medical Bulletin 2006;79(80):171-86.
  • Gallagher BM, Anasri A, Atkins M, et al Radiopharmaceuticals XXVII. 18F- FDG metabolism in vivo. Tissue distribution and imaging studies in animals. J Nucl Med 1977;18(10):990-6.
  • Shalom RB, Valdivia AY, Blaufox MD. PET imaging in oncology. Seminars in Nuclear Medicine 2000;30(3):150-85.
  • Ruhlman J, Oehr P, Biersack HJ (eds). PET in Oncology: Basic and Clinical Applications. Berlin Heidelberg: Springer, 1999:89–101.
  • Dominique D, Edward C, Milton G, et al. Procedure Guideline for Tumor Imaging with 18F-FDG PET/CT. http://jnm.snmjournals.org/cgi/reprint/47/5/885.pdf.
  • Hubner KF, McDonald TW, Niethammer JG, et al. Assessment of primary and metastatic ovarian cancer by positron emission tomography (PET) using 2-(18F) deoxyglucose (2-18F FDG). Gynecol Oncol 1993;51(2):197-204.
  • Schröder W, Zimny M, Rudlowski C, et al. The role of 18-F-FDG PET in diagnosis of ovarian cancer. Int J Gynecol Cancer 1999;9(2):117-22.
  • Zimny M, Schröder W, Wolters S, et al. FDG PET in ovarian carcinoma: methodology and preliminary results. Nuklearmedizine 1997;36(7):228-33.
  • Grab D, Flock F, Stohr I, et al. Classification of asymptomatic adnexal masses by ultrasound, magnetic resonance imaging, and positron emission tomography. Gynocol Oncol 2000;77(3):454-9.
  • Zimny M, Siggelkow W, Schroder W et al. 2-(fluorine-18)-fluoro-2-deoxy-D-glucose. Positron emission tomography in the diagnosis of recurrent ovarian cancer. Gynecol Oncol 2001;83(2):310-5.
  • Sella T, Rosenbaum E, Edelmann DZ, et al. Value of chest CT scans in routine ovarian carcinoma follow- up. AJR Am J Roentgenol 2001; 177(4):857-9.
  • Sebastian S, Lee SI, Horowitz NS et al. PET-CT vs. CT alone in ovarian cancer recurrence. Abdom Imaging 2008; 33(1):112-8.
  • Torizuka T, Nobezawa S, Kanno T, et al. Ovarian cancer recurrence: role of whole-body positron emission tomography using 2-(fluorine-18)-fluoro-2-deoxy-D-glucose. Eur J Nucl Med Mol Imaging 2002;29 (6):797-803.
  • Sironi S, Messa C, Mangili G, et al. Integrated FDG PET/CT in patients with persistent ovarian cancer: correlation with histologic findings. Radiology 2004;233(2):433-40.
  • Torizuka T, Nobezavwa S, Kanno T, et al. Ovarian cancer recurrence: role of whole–body positron emission tomography using 2-(fluorine-18)-fluoro-2-deoxy-D-glucose. Eur J Nucl Med 2002;29(6): 797–803.
  • Rubin SC, Hoskins WJ, Hakes TB, et al. Serum CA 125 levels and surgical findings in patients undergoing secondary operations for epithelial ovarian cancer. Am J Obstet Gynecol 1989;160(3):667-71.
  • Martinez-Roman S, Ramirez PT, Oh J, et al. Combined positron emission tomography and computed tomography for the detection of recurrent ovarian mucinous adenocarcinoma. Gynecol Oncol 2005;96(3):888–91.
  • Berger KL, Nicholson SA, Dehdashti F, et al. FDG PET evaluation of mucinous neoplasms: correlation of FDG uptake with histopathologic features. AJR 2000;174(4):1005-8.
  • Chung HH, Kang WJ, Kim JW, et al. Role of FDG PET/CT in the assessment of suspected recurrent ovarian cancer: correlation with clincal or histological findings. Eur J Nucl Med Mol Imaging 2007; 34(4):480-6.
  • Alla T, Henry W Yeung , Aida Sanchez S, et al. Peritoneal Carcinomatosis: Role of FDG-PET. J Nucl Med 2003; 44(9):1407-12.
  • Karlan BY, Hawkins R, Hoh C, et al. Whole-body positron emission tomography with 2-(fluorine-18)- fluoro-2-deoxy-D-glucose can detect recurrent ovarian carcinoma. Gynecol Oncol 1993;51(2):175-81.
  • Kubik-Huch RA, Dorffler W, Von Schulthess GK, et al. Value of 18F-FDG positron emission tomography, computed tomography, and magnetic resonance imaging in diagnosing primary and recurrent ovarian carcinoma. Eur Radiol 2000;10(5):761-7.
  • Rose PG, Faulhaber P, Miraldi F, et al. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol 2001;82(1):17-21.
  • Nakamoto Y, Saga T, Ishimori T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. AJR Am J Roentgenol 2001;176(6):1449-54.
  • Schroder W, Zimny M, Rudlowski C, et al. The role of 2-(fluorine-18)-fluoro-2-deoxy-D-glucose ( 18 F-FDG PET) in diagnosis of ovarian cancer. Int J Gynecol Cancer 1999;9(2):117-122.