FDG-PET/CT as a molecular biomarker in ovarian cancer

In the clinical setting the vast majority of positron emission tomography (PET) procedures use the glucose analogue F-18 fluorodeoxyglucose (FDG) to visualize the increased glucose consumption of malignant lesions. Co-registered PET/CT has improved the diagnostic accuracy compared to either imaging procedure alone, particularly in ovarian cancer. FDG-PET/CT demonstrates primary malignant ovarian tumors; however, it is often unable to accurately differentiate between benign and malignant pelvic masses and to visualize borderline ovarian tumors. FDG-PET/CT has a suggested role for staging, by improving treatment planning in individual cases, but it is particularly helpful in the setting of disease recurrence when CA125 tumor marker levels are rising and conventional imaging (CT or MR) is inconclusive or negative. The aim of this review is to demonstrate the value of FDG-PET-CT in diagnosis and management of patients with ovarian malignancies, outlining its advantages and limitations.