title: Pseudomyxoma peritonei: role of 18F-FDG PET in preoperative evaluation of pathological grade and potential for complete cytoreduction.
abstract: BACKGROUND
  For pseudomyxoma peritonei (PMP), survival depends on pathological grade and completeness of cytoreductive surgery. The aim of the study was to assess the ability of preoperative 18F-FDG PET to determine these 2 prognosis indicators.
  
  
  METHODS
  In this prospective single centre study, all patients presenting with PMP were included. They underwent a preoperative 18F-FDG PET with a double radiological evaluation and an explorative laparotomy with the objective of optimal cytoreduction followed by a hyperthermic intra-operative intraperitoneal chemotherapy (HIPEC). Patients with non resectable disease underwent debulking surgery without HIPEC. The Completeness of Cytoreduction was assessed by CC score.
  
  
  RESULTS
  Thirty-four patients were included. PET scanning was positive for 19 patients with grade II (hybrid form) or III (Peritoneal Mucinous Carcinomatosis) and for 2 patients with grade I (disseminated peritoneal adenomucinosis), and negative for 3 patients with grade II - III and for 10 patients with grade I. PET scanning was positive for 6 patients with CC score 2 - 3 and for 16 patients with CC score 0, and negative for 2 patients with CC score 2 - 3 and for 10 patients with CC score 0. The 18F-FDG PET interpretation distinguished 2 patients groups (grade I and grade II - III) with a sensitivity of 90% and a specificity of 77%. Moreover, probability of complete cytoreduction when PET was negative was over 80%.
  
  
  CONCLUSIONS
  Preoperative 18F-FDG PET may predict pathological grade and completeness of cytoreduction which are the two main prognostic factors in patients with PMP.
authors.affiliation: Department of oncologic surgery, Centre Hospitalier Lyon Sud, Pierre Bénite, France.
authors.forename: G
authors.initials: G
authors.lastname: Passot
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.forename: O
authors.initials: O
authors.lastname: Pellet
authors.forename: S
authors.initials: S
authors.lastname: Isaac
authors.forename: C
authors.initials: C
authors.lastname: Tychyj
authors.forename: F
authors.initials: F
authors.lastname: Mohamed
authors.forename: F
authors.initials: F
authors.lastname: Giammarile
authors.forename: F N
authors.initials: FN
authors.lastname: Gilly
authors.forename: E
authors.initials: E
authors.lastname: Cotte
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011553:Pseudomyxoma Peritonei / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18