Computed tomography in evaluation of patients with ovarian carcinoma in complete clinical remission. Correlation with surgical-pathologic findings

Abstract

Computed tomography (CT) of the abdomen and pelvis was performed in 47 patients who were in complete clinical remission from ovarian carcinoma. Results of CT were correlated with surgical-pathologic findings at surgical reexploration. Overall, CT had a sensitivity of 0.32, specificity of 0.77, positive predictive value of 0.79, and negative predictive vlaue of 0.30. Accuracy of CT did not vary by intraperitoneal or retroperitoneal site studied. Computed tomography detected only 7% of tumor nodules 1 cm or less in diameter and only 37% of nodules over 1 cm in diameter. The utility of CT in this clinical setting was limited to approximately 20% of patients with true-positive CT findings who might have been saved surgical reexploration. Due to a high false-negative rate, a normal CT cannot replace a second-look laparotomy for accurate assessment of disease status.