• Azahara Palomar Muñoz, José Manuel Cordero García, Prado Talavera Rubio, Ana M García Vicente, Beatriz González García, María Emiliana Bellón Guardia, Ángel Soriano Castrejón, and Enrique Aranda Aguilar.
• Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain; Servicio de Medicina Nuclear, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: azapalomar@gmail.com.
• Med Clin (Barc). 2018 Aug 10; 151 (3): 97-102.

Background And ObjectiveTo assess the usefulness of cancer antigen 125 (CA125) serum levels and kinetic values, velocity (CA125vel) and doubling time (CA125dt), as well as fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT), in the detection of ovarian cancer recurrence. To assess the optimal cut-off for CA125, CA125vel and CA125dt to detect relapse with [18F]FDG-PET/CT.Material And MethodsA retrospective analysis was performed of 59 [18F]FDG-PET/CT (48 patients) for suspected recurrence of ovarian cancer. Receiver operating characteristic (ROC) curves were plotted and area-under-the curve (AUC) statistics were computed for CA125, CA125vel and CA125dt. The results obtained in the group with normal and high (>35U/ml) CA125 levels were compared.ResultsForty-four cases of recurrence were diagnosed (7 had CA125 ≤35U/ml), whereas 15 showed no disease. All of them were correctly catalogued by PET/CT. In ROC analysis, the discriminatory power of CA125 was relatively high (AUC 0.835) and the optimal cut-off point to reflect active disease was 23.9U/ml. The ROC analyses for the CA125vel and CA125dt showed an AUC of 0.849 and 0.728, respectively, with an optimal cut-off point of 1.96U/ml/month and 0.76 months, respectively. In patients with normal CA125 and recurrence of ovarian cancer, the CA125vel was significantly higher than in patients without recurrence (p=0.029).Conclusion[18F]FDG-PET/CT is more accurate than CA125 parameters in the detection of ovarian cancer recurrence. CA125 serum levels are essential; nevertheless, CA125 kinetic values must be considered to detect relapse. Particularly in patients with CA125 within normal values, in which a higher CA125vel is indicative of recurrence.Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

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