title: Peritoneal carcinomatosis: comparison of dynamic contrast-enhanced magnetic resonance imaging with surgical and histopathologic findings.
abstract: OBJECTIVE
  In patients with peritoneal carcinomatosis (PC) accurate preoperative assessment is essential to determine indication and surgical procedure to ensure optimal outcome. Purpose of our study was to assess the diagnostic accuracy (DA) of multiphasic dynamic contrast-enhanced MRI to determine the extent of PC in correlation with surgical and histopathological findings.
  
  
  METHODS
  14 Patients with proven PC were examined on a 1.5T system before peritonectomy and hyperthermic intraperitoneal chemotherapy. Patient preparation included oral application of 2000 mL mannitol solution and 40 mg butylscopolaminiumbromid i.v. Coronal contrast-enhanced multiphasic dynamic T1w 3D gre sequences (T1W DCE) (0.15 mmol Gd-chelate/kg bw) covering the whole abdomen were acquired (TR 2.9 ms, TE 1.1 ms, resolution 2.0 × 2.0 × 1.8 mm, FOV 400 × 400 mm). MRI was assessed by two radiologists and correlated with surgical exploration (SE) and histopathology for each segment based on the peritoneal cancer index proposed by Sugarbaker et al.
  
  
  RESULTS
  In total, 182 segments were evaluated. PC was found in 118/121 of 182 segments (reader 1/2) by MRI and in 131 segments by SE. In 4/7 segments MRI was false positive. False negative segments 17/17 in MRI did not result in irresectability. The positive predictive value for PC per segment of MRI was 97%/94%, the negative predictive value 73%/72%, the sensitivity 87%/87% and the specificity 92%/86%. The DA was 88%/87%.
  
  
  CONCLUSIONS
  T1W DCE is an accurate and clinical valuable tool for the preoperative assessment of peritoneal tumor spread.
authors: Department for Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany. Bernhard.klumpp@med.uni-tuebingen.de
authors: Bernhard Daniel
authors: BD
authors: Klumpp
authors: Philip
authors: P
authors: Aschoff
authors: Nina
authors: N
authors: Schwenzer
authors: Michael
authors: M
authors: Fenchel
authors: Ingmar
authors: I
authors: Koenigsrainer
authors: Claudius
authors: C
authors: Falch
authors: Bjoern
authors: B
authors: Bruecher
authors: Claus D
authors: CD
authors: Claussen
authors: Alfred
authors: A
authors: Koenigsrainer
authors: Christina
authors: C
authors: Pfannenberg
authors: Ulrich
authors: U
authors: Kramer
authors: Stephan
authors: S
authors: Miller
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media