The Ovary
Premenopausal:
- The normal premenopausal ovary typically demonstrates little or no FDG uptake.
- Moderate or even intense metabolic activity in a premenopausal ovary (unilateral or bilateral) is nearly always a normal finding — in the absence of an associated CT abnormality.
- We generally report:
- “The left ovary is moderately FDG-avid (SUV 2.2). As an associated soft tissue abnormality is not identified on the co-registered CT images, this uptake is presumed physiologic in a premenopausal woman.”
Postmenopausal:
- The normal postmenopausal ovary is non-avid.
- While the normal postmenopausal ovary can demonstrate varying degrees of metabolic activity, further evaluation is recommended for any postmenopausal ovary with uptake above blood pool background – even in the absence of an associated CT abnormality.
- We generally report:
- “The left ovary is moderately FDG-avid (SUV 2.2). Although an associated soft tissue lesion is not demonstrated on the co-registered non-contrast CT images, ultrasound correlation may be warranted in a postmenopausal woman.”
Ovarian Cysts:
Non-avid ovarian cysts measuring less than 5.0 cm in premenopausal women are presumed functional, as long as solid elements are not present on the co-registered non-contrast CT images (if greater than 4.0 cm, we recommend a 6-week follow up ultrasound, even though they are still likely functional).
We typically report, “A 3.5 x 3.0 cm non-avid left ovarian cyst is noted, presumed functional in a premenopausal woman.“
Ovarian cysts (as are nearly all cysts in the body) should be non-avid. If an ovarian cyst demonstrates FDG uptake (especially is the uptake is focal), ultrasound correlation is recommended.In a postmenopausal woman, even a non-avid ovarian cyst warrants closer attention. We generally report, “A 3.5 x 3.0 cm non-avid left ovarian cyst is present. Although non-avid, the finding of an ovarian cyst in a post-menopausal woman warrants close clinical assessment.”
