Role of chest CT in the follow-up of ovarian adenocarcinoma

Abstract

Objective: We describe the prevalence of metastatic chest disease in ovarian adenocarcinoma as seen on CT. We sought to determine whether routine chest CT added any pertinent information to the follow-up examination of patients with ovarian adenocarcinoma.

Materials and methods: Retrospective review of our tumor registry yielded 96 patients with ovarian adenocarcinoma who had only a single primary malignancy and at least one CT scan of the chest, abdomen, and pelvis. CT scans were reviewed to assess the presence of metastatic chest disease in relation to disease activity in the abdomen and pelvis. Chest CT findings were correlated with the physical examination findings and CA-125 levels and were reviewed in consultation with a gynecologic oncologist to select only those patients with chest abnormalities attributable to metastatic disease.

Results: A total of 266 CT scans were obtained. Forty (41.7%) of the 96 patients had abnormalities attributable to metastatic chest disease on one or more scans. In the absence of disease progression in the abdomen and pelvis, chest disease progression was seen in only six (2.7%) of the 226 follow-up CT scans. Five of the six patients had rising CA-125 levels.

Conclusion: Correlation of the findings of abdominal and pelvic CT with the physical findings and the CA-125 levels serves as effective follow-up in patients with ovarian adenocarcinoma. The contribution of additional chest CT in these patients is small.