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Positron Emission Tomography/Computed Tomography for Gynecologic Malignancies. Obstet Gynecol Surv 2016; 71:545-56. [DOI: 10.1097/ogx.0000000000000345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Seino H, Ono S, Miura H, Morohashi S, Wu Y, Tsushima F, Takai Y, Kijima H. Hypoxia is important in F‑18 FDG accumulation in thecoma‑fibroma tumors on F‑18 FDG PET/CT scans. Mol Med Rep 2016; 13:3821-7. [PMID: 27035330 PMCID: PMC4838157 DOI: 10.3892/mmr.2016.5016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 08/04/2015] [Indexed: 11/24/2022] Open
Abstract
Several studies have noted benign thecoma-fibroma tumors with positive F-18 fluorodeoxyglucose (FDG) accumulation mimicking malignant ovarian tumors following F-18 FDG positron emission tomography (PET). The present study analyzed four cases with false-positive F-18 FDG PET/computed tomography (CT) diagnoses of thecoma-fibroma tumors as malignant tumors due to F-18 FDG accumulation, compared with eight cases of FDG-positive ovarian cancers and two cases of FDG-negative fibromas. Hypoxia inducible factor (HIF)-1α expression was examined in the six thecoma-fibroma tumors using reverse transcription-polymerase chain reaction (RT-PCR). The four F-18 FDG-positive cases exhibited higher cellularity, maximum standard uptake and signal intensity on T2-weighted imaging, and gadolinium (Gd) enhancement using magnetic resonance imaging than the two FDG-negative fibroma cases. In the F-18 FDG-positive thecoma-fibroma group, Ki-67 expression was low and LAT1 expression was not identified, ruling out the diagnosis and potential for malignancy. However, considerable glucose transporter 1, HIF-1α, and vascular endothelial growth factor expression was observed. HIF-1α expression was elevated in all four false-positive cases by RT-PCR. From these results, it was hypothesized that hypoxia due to elevated cellularity may stimulate HIF-1α expression and be associated with F-18 FDG accumulation in F-18-positive thecoma-fibroma tumors.
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Affiliation(s)
- Hiroko Seino
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Shuichi Ono
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Hiroyuki Miura
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Satoko Morohashi
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Yunyan Wu
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Fumiyasu Tsushima
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Yoshihiro Takai
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
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Kumar Dhingra V, Kand P, Basu S. Impact of FDG-PET and -PET/CT imaging in the clinical decision-making of ovarian carcinoma: an evidence-based approach. ACTA ACUST UNITED AC 2012; 8:191-203. [PMID: 22375721 DOI: 10.2217/whe.11.91] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The most definitive role of fluorodeoxyglucose (FDG)-PET/computed tomography (CT) at present is surveillance and detecting recurrence in patients who have completed primary therapy but demonstrate a rising serum tumor marker (e.g., CA-125 levels). In this scenario, PET/CT demonstrates high sensitivity and accuracy in detecting lesions that are otherwise challenging, and appears superior (with less interobserver variability) compared with CT alone. Despite the fact that peritoneal deposits may be missed by PET/CT, the overall performance is better than CT alone. FDG-PET does not play a significant additional role in the primary diagnosis of ovarian cancers; however, the role of combined PET/CT modality has recently begun to be re-explored for initial disease staging, particularly because PET/CT can pick up small unsuspected lesions and thereby provide a better disease assessment of the whole body in a single examination. The baseline PET/CT also subserves an important role for future monitoring of therapy response. Therapy monitoring by PET could help to optimize neoadjuvant therapy protocols and to avoid ineffective therapy in nonresponders early in its course, although PET/CT has cost-effectiveness issues that need further evaluation. The prognostic value of FDG-PET/CT has been investigated in the following areas: in the preoperative setting to predict optimal cytoreduction; to assess the value of a positive FDG-PET following primary surgery; and when employed as a replacement for second-look laparotomy following completion of primary surgery and chemotherapy. The data, although promising, are still sparse in all the three domains for a definite recommendation.
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Affiliation(s)
- Vandana Kumar Dhingra
- Department of Nuclear Medicine, Cancer Research Institute, HIHT, Dehradun, Uttrakhand, India
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Ovarian Thecoma Mimicking Carcinoma on F-18 FDG PET in a Postmenopausal Woman With Elevated CA-125. Clin Nucl Med 2011; 36:1133-4. [DOI: 10.1097/rlu.0b013e3182335e57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ho KC, Ng KK, Yen TC, Chou HH. An ovary in luteal phase mimicking common iliac lymph node metastasis from a primary cutaneous peripheral primitive neuroectodermal tumour as revealed by 18-fluoro-2-deoxyglucose positron emission tomography. Br J Radiol 2005; 78:343-5. [PMID: 15774596 DOI: 10.1259/bjr/95232584] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 30-year-old female underwent surgical removal of a primary cutaneous peripheral primitive neuroectodermal tumour (PNET) of the left thigh. A subsequent 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) scan showed abnormal accumulation of FDG in the left upper pelvic region, consistent with metastasis to a left common iliac node. A series of follow-up imaging studies revealed that a cyst of the corpus luteum of ovary was responsible for the abnormal FDG accumulation.
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Affiliation(s)
- K-C Ho
- Department of Nuclear Medicine, Chang Gung Memorial Hospital and University, Taoyuan, Taiwan
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Behrend M, Kaaden S, Von Wasielewski R, Frericks B. Benign retroperitoneal schwannoma mimicking an adrenal mass. Surg Laparosc Endosc Percutan Tech 2003; 13:133-8. [PMID: 12709623 DOI: 10.1097/00129689-200304000-00016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adrenal tumors are frequently incidental discoveries, and the therapy for them is the subject of controversial discussions. We report herein on such an incidentaloma, which proved to be a benign retroperitoneal schwannoma. A 48-year-old female with an unclear adrenal mass underwent retroperitoneoscopic tumor extirpation. A well-defined tumor that displaced the adrenal gland and adhered firmly to only one retroperitoneal nerve was discovered. The en bloc resection was performed without problem. The histopathologic examination revealed a benign schwannoma. Retroperitoneal schwannomas can mimic a multitude of different conditions. Because imaging methods frequently do not yield distinct results, quite often only the operative exploration can establish a definitive diagnosis. In a case of unclear retroperitoneal findings, an endoscopic extirpation should be considered.
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Affiliation(s)
- Matthias Behrend
- Klinik für Viszeral und Transplantationschirurgie, Institut für Pathologie, Hannover, Germany
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