title: Value of 18F-FDG PET in the detection of peritoneal carcinomatosis.
abstract: OBJECTIVE
  Peritoneal carcinomatosis can be difficult to diagnose using computed tomography (CT). The purpose of this study was to evaluate the role of 2-(fluorine 18) fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the detection of peritoneal carcinomatosis.
  
  
  METHODS
  We reviewed the CT and FDG PET radiological reports and clinical charts of 18 patients with peritoneal carcinomatosis and 17 cancer patients without peritoneal carcinomatosis. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUVmax) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured.
  
  
  RESULTS
  The sensitivity and positive predictive value (PPV) of combined FDG PET and CT were superior to those of CT alone for the detection of peritoneal lesions (sensitivity: 66.7% vs 22.2%, p<0.025; PPV: 92.3% vs 50.0%, p<0.05). The most frequent pattern of FDG uptake in patients with peritoneal carcinomatosis was abnormally intense focal uptake near the abdominal wall. An SUVmax threshold of 5.1 produced a diagnostic accuracy of combined FDG PET and CT of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 14 patients (40.0%), and led to alteration of the therapeutic strategy in five (14.3%) of the enrolled cancer patients.
  
  
  CONCLUSIONS
  We found that use of an intra-abdominal FDG uptake cut-off value for SUVmax of >5.1 assists in the diagnosis of peritoneal carcinomatosis. FDG PET may play an important role in the clinical management of patients with suspected peritoneal carcinomatosis.
authors.affiliation: Department of Radiology, School of Medicine, Yokohama City University, Yokohama-shi, Kanagawa-ken, Japan. akiko225@yokohama-cu.ac.jp
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kawano
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Takahashi
authors.forename: Jin
authors.initials: J
authors.lastname: Lee
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nakagami
authors.forename: Etsuko
authors.initials: E
authors.lastname: Miyagi
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
mesh_terms: D002277:Carcinoma / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18