64-Section multi-detector row CT in the preoperative diagnosis of peritoneal carcinomatosis: correlation with histopathological findings.
BACKGROUND
To prospectively investigate the diagnostic accuracy of a 64-section multi-detector row computed tomography (CT) for the detection of peritoneal metastases, with the use of surgery and histopathological findings as the reference standard.


METHODS
The study cohort comprised 18 patients with peritoneal carcinomatosis who underwent multiphasic CT with a 64-section CT, 0-119 days before cytoreductive surgery. Transverse CT images along with isotropic reformatted coronal and sagittal images were prospectively and independently evaluated by one of the five staff radiologists in an unblinded fashion.


RESULTS
The overall sensitivity, specificity, positive, and negative predictive values of CT for the detection of peritoneal metastases were, respectively, 75% (93 of 124 lesions; confidence interval [CI] 68-84), 92% (118 of 128; CI 85-96), 90% (93 of 103; CI 83-95), and 79% (118 of 149; CI 72-86). For lesions 0.5 cm in diameter or larger, CT yielded a mean sensitivity of 89% (77 of 87; CI 75-97), although sensitivity decreased to only 43% (16 of 37; CI 28-56) for lesions <0.5 cm in diameter.


CONCLUSIONS
64-Section CT with the addition of isotropic reformatted coronal and sagittal images is a very effective technique in the detection of peritoneal metastases of 0.5 cm in diameter or larger, although sensitivity decreases remarkably for lesions <0.5 cm in diameter.
Marin
Daniele
D
Department of Radiological Sciences, University of Rome Sapienza, Italy.
Catalano
Carlo
C
Baski
Mahbubeh
M
Di Martino
Michele
M
Geiger
Daniel
D
Di Giorgio
Angelo
A
Sibio
Simone
S
Passariello
Roberto
R
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C057937:iomeprol; D003974:Diatrizoate Meglumine; D007479:Iopamidol