Florencia Virili, Andreas Obermair, Saira Sanjida, James L Nicklin, Andrea Garrett, Russell Land, Amy Tang, Louise Campbell, Val Gebski, Paul Thomas
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The secondary objective was to estimate changes in the International Federation of Gynecology and Obstetrics (FIGO) stage and clinical management resulting from gated PET/CT.</p><p><strong>Methods: </strong>The IMAGE trial is a non-randomized phase II clinical trial comparing standard CT scanning with gated PET/CT in diagnosing thoracic involvement in a non-selected group of patients with suspected ovarian cancer on a contrast CT scan. Three sets of PET images were obtained comprising an ungated 2 min whole body image, a static 7.5 min image of the upper abdomen and thorax, and a gated end-expiratory image over the upper abdomen and thorax. Images were evaluated for specificity, sensitivity, diagnostic accuracy, and the proportion of patients with changes in FIGO stage and subsequent clinical management was compared between imaging techniques.</p><p><strong>Results: </strong>A total of 84 patients were enrolled based on a standard CT scan, 67 of whom were eligible for gated PET/CT scans. Diagnostic accuracy with gated PET/CT was more than 80% for lesions in lung, liver, extra-abdominal sites, and pleura, but less than 50% for extra-abdominal lymph nodes. Compared with CT scan at baseline, 46% of patients who had 7.5 min gated PET/CT had disease upstaged from stage III to IV, and 8% had disease downstaged from stage IV to III. However, this led to a change of management in only 5% of patients.</p><p><strong>Conclusions: </strong>Gated PET/CT enables upstaging; however, in our institution it altered clinical management only in a minority of patients.</p><p><strong>Trial registration number: </strong>NCT02258165.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":" ","pages":""},"PeriodicalIF":4.1000,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of gated FDG PET/CT on the staging of patients with suspected or proven newly diagnosed advanced epithelial ovarian, fallopian tube, and primary peritoneal cancer: results from a non-randomized, phase II clinical trial.\",\"authors\":\"Florencia Virili, Andreas Obermair, Saira Sanjida, James L Nicklin, Andrea Garrett, Russell Land, Amy Tang, Louise Campbell, Val Gebski, Paul Thomas\",\"doi\":\"10.1136/ijgc-2024-005633\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Imaging for staging ovarian cancer is important to determine the extent of disease. 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引用次数: 0
摘要
目的：对卵巢癌进行分期的影像学检查对于确定疾病的范围非常重要。本研究的主要目的是比较门控 18F- 氟脱氧葡萄糖正电子发射计算机断层扫描（FDG PET/CT）和静脉注射造影剂的标准 CT 扫描，以便在治疗前诊断晚期卵巢癌患者的胸部受累情况。次要目标是估计门控 PET/CT 对国际妇产科联盟（FIGO）分期和临床管理的影响：IMAGE 试验是一项非随机的 II 期临床试验，该试验比较了标准 CT 扫描与门控 PET/CT 在诊断对比 CT 扫描中疑似卵巢癌患者的胸部受累情况。共获得三组 PET 图像，包括 2 分钟的非门控全身图像、7.5 分钟的上腹部和胸部静态图像以及上腹部和胸部的门控呼气末图像。对图像的特异性、敏感性和诊断准确性进行了评估，并比较了不同成像技术下 FIGO 分期发生变化的患者比例和随后的临床治疗情况：结果：共有 84 名患者根据标准 CT 扫描结果入选，其中 67 人符合选通 PET/CT 扫描的条件。门控 PET/CT 对肺、肝、腹腔外部位和胸膜病变的诊断准确率超过 80%，但对腹腔外淋巴结的诊断准确率低于 50%。与基线 CT 扫描相比，接受 7.5 分钟门控 PET/CT 检查的患者中，46% 的病变从 III 期升至 IV 期，8% 的病变从 IV 期降至 III 期。然而，只有5%的患者因此改变了治疗方案：结论：门控 PET/CT 可使病情向上分期，但在我们医院，它只改变了少数患者的临床治疗：NCT02258165.
Impact of gated FDG PET/CT on the staging of patients with suspected or proven newly diagnosed advanced epithelial ovarian, fallopian tube, and primary peritoneal cancer: results from a non-randomized, phase II clinical trial.
Objective: Imaging for staging ovarian cancer is important to determine the extent of disease. The primary objective of this study was to compare gated 18F-fluorodeoxyglucose positron emission tomography coupled with computed tomography (FDG PET/CT) and standard CT scan with intravenous contrast to diagnose thoracic involvement in patients with advanced ovarian cancer prior to treatment. The secondary objective was to estimate changes in the International Federation of Gynecology and Obstetrics (FIGO) stage and clinical management resulting from gated PET/CT.
Methods: The IMAGE trial is a non-randomized phase II clinical trial comparing standard CT scanning with gated PET/CT in diagnosing thoracic involvement in a non-selected group of patients with suspected ovarian cancer on a contrast CT scan. Three sets of PET images were obtained comprising an ungated 2 min whole body image, a static 7.5 min image of the upper abdomen and thorax, and a gated end-expiratory image over the upper abdomen and thorax. Images were evaluated for specificity, sensitivity, diagnostic accuracy, and the proportion of patients with changes in FIGO stage and subsequent clinical management was compared between imaging techniques.
Results: A total of 84 patients were enrolled based on a standard CT scan, 67 of whom were eligible for gated PET/CT scans. Diagnostic accuracy with gated PET/CT was more than 80% for lesions in lung, liver, extra-abdominal sites, and pleura, but less than 50% for extra-abdominal lymph nodes. Compared with CT scan at baseline, 46% of patients who had 7.5 min gated PET/CT had disease upstaged from stage III to IV, and 8% had disease downstaged from stage IV to III. However, this led to a change of management in only 5% of patients.
Conclusions: Gated PET/CT enables upstaging; however, in our institution it altered clinical management only in a minority of patients.
期刊介绍：
The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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