Staging Ovarian Cancer Using FDG PET/CT

A presentation of the role of FDG PET combined with CT plays in depicting recurrent ovarian cancer.

Course ID: Q00320 Category:
Modalities: , ,

2.5

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.00
Procedures: 1.00
Abdomen and Pelvis: 1.00

Magnetic Resonance Imaging: 1.00
Procedures: 1.00
Body: 1.00

Nuclear Medicine Technology: 2.00
Procedures: 2.00
Endocrine and Oncology Procedures: 2.00

Registered Radiologist Assistant: 2.50
Patient Care: 0.50
Patient Management: 0.50
Procedures: 2.00
Abdominal Section: 2.00

Sonography: 1.00
Procedures: 1.00
Gynecology: 1.00

Radiation Therapy: 2.00
Patient Care: 1.00
Patient and Medical Record Management: 1.00
Procedures: 1.00
Treatment Sites and Tumors: 1.00

Outline

  1. Introduction
  2. Ovarian Cancer
  3. Patterns of Spread of Ovarian Cancer
  4. Imaging of Recurrent Ovarian Cancer
  5. PET/CT Findings of Ovarian Cancer Metastases
    1. Peritoneal Metastases
    2. Lymph Node Metastases
    3. Distant Organ Metastases
  6. Evaluation of Response to Therapy
  7. Pitfalls of PET/CT
  8. Conclusions

Objectives

Upon completion of this course, students will:

  1. be familiar with the most common causes of mortality in women with gynecological cancers
  2. be familiar with initial treatments for ovarian cancer
  3. be familiar with recurrence rate in women in ovarian cancer (post-surgical)
  4. understand why PET/CT may be a useful diagnostic techniques for detection of ovarian cancer recurrence
  5. understand which diagnostic techniques may have limited predictive value in the identification of ovarian cancer recurrence
  6. understand the advantages of FDG PET/CT for the detection of ovarian cancer recurrences
  7. understand that ovarian cancer is a malignancy that is frequently diagnosed at an advanced stage, that is, in three-quarters of women with ovarian cancer
  8. be familiar with the five-year survival rates for patients with early stage and advanced stage disease
  9. understand that the cornerstone of management for women with ovarian cancer is surgery
  10. be familiar with the guidelines of the National Comprehensive Cancer Network for the diagnosis of ovarian cancer
  11. be familiar with the treatment modalities that can prolong survival in women with recurrent ovarian cancer
  12. be familiar with the path of tumor metastasis via lymph nodes
  13. be familiar with the proportion of patients with Stages I, II, III-IV ovarian cancer malignancies with lymph node involvement
  14. be familiar with difficulties in identifying small ovarian cancer metastasis
  15. be familiar with sensitivity of FDG PET/CT for detection of recurrent cancer
  16. be familiar with the specificity of FDG PET/CT for detection of recurrent cancer
  17. be familiar with the sensitivity of MRI for the detection of recurrent cancer
  18. be familiar with the specificity of MRI for the detection of recurrent cancer
  19. understand how metabolic activity with FDG PET/CT imaging allows visualization of peritoneal metastases
  20. be familiar with the type of fluid vessel or vasculature or circulation that carries metastatic ovarian tumor cells
  21. be familiar with at least three of the structures to which peritoneal fluid carries metastatic tumor cells
  22. be familiar with the percentage of patients in whom gravity facilitates spread of malignancy
  23. be familiar with how ovarian cancer tumor cells seed the sigmoid mesocolon
  24. understand the definition of Sister Mary Joseph nodules
  25. be familiar with how retained embryofetal structures with residual patency may provide routes of metastasis
  26. be familiar with how often lymphatic dissemination occurs in women with early stage ovarian cancer
  27. understand which types of lymph node ovarian cancer metastases are not well detected with FDG PET/CT
  28. be familiar with common findings on FDG PET/CT in stage IV (advanced) ovarian cancer
  29. be familiar with the sensitivity of FDG PET/CT for detecting distant metastasis
  30. be familiar with which diagnostic techniques work for assessing response to therapy
  31. be familiar with how FDG PET/CT findings can predict overall survival of women with ovarian cancer
  32. be familiar with the characteristics which may complicate FDG PET/CT response assessment in ovarian cancer patients who have been administered chemotherapy
  33. understand which characteristics may complicate FDG PET/CT response assessment independent of treatment modality
  34. understand that caution in interpreting FDG PET/CT findings needs to be exercised for at least 6 months post-surgery
  35. understand the role of FDG PET/CT when other studies such as MRI are negative