Staging of peritoneal carcinomatosis: enhanced CT vs. PET/CT.
OBJECTIVE
To assess and compare the performance of CT and 18F-FDG-PET/CT in the evaluation of peritoneal carcinomatosis (PC).


METHODS
Thirty consecutive patients with PC and scheduled for a surgery underwent a CT of the abdomen and pelvis and a whole-body 18F-FDG PET/CT. The extent of PC was assessed precisely using the peritoneal cancer index combining the distribution of tumor throughout 11 abdominopelvic regions with a lesion size score. CT and PET/CT imaging results were compared in all patients with intraoperative findings using an interclass correlation test.


RESULTS
The presence of PC was correctly determined on CT and PET/CT in 23/28 and 16/28 patients, respectively. The extent of PC was understaged with CT and PET/CT in 27 patients and overstaged with CT and PET/CT in 1 and 2 patients, respectively. The interclass correlation was 0.53 (moderate) between CT and surgery and 0.12 (low) between PET/CT and surgery. The interclass correlation was higher for mucinous tumor (0.63) than for non-mucinous (0.16) on CT imaging whereas no difference was found in PET/CT.


CONCLUSIONS
The intraperitoneal assessment of the extent of carcinomatosis, necessary to assess prognosis and treatment planning, is not accurate enough with CT and PET/CT imaging.
Dromain
Clarisse
C
Department of Radiology, Institut Gustave-Roussy, 39, rue Camille Desmoulins, 94805, Villejuif Cedex, France. dromain@igr.fr
Leboulleux
Sophie
S
Auperin
Anne
A
Goere
Diane
D
Malka
David
D
Lumbroso
Jean
J
Schumberger
Martin
M
Sigal
Robert
R
Elias
Dominique
D
D000328:Adult; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006801:Humans; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007472:Iohexol