Fig. 3

The preoperative whole body PET/CT maximum intensity projection view of the patient with FIGO stage IIIC high grade EOC show, in addition to the abdominal involvement, an extensive FDG uptake in cardiophrenic, parasternal, mediastinal, subclavicular, neck and axillary lymph nodes (a). After 3 cycles of NACT, an interval debulking surgery (with no gross residual disease) and 3 cycles of standard adjuvant taxane-platinum based chemotherapy the FDG uptake has been normalized (b). PET/CT performed 11 months after the end of primary treatment shows metabolic reactivation of paraaortal and supradiaphragmatic lymph nodes as well as new metabolically active supradiaphragmatic lymph nodes (c). Transaxial PET/CT fusion images show the preoperatively detected FDG-avid lymph node profile during treatment and relapse in the neck (d,e,f) as well as in the axillary (white arrow) and mediastinal (yellow arrow) (g,h,i) regions