Use of (18)F-FDG PET/CT in the preoperative evaluation of patients diagnosed with peritoneal carcinomatosis of ovarian origin, candidates to cytoreduction and hipec. A pending issue.
OBJECTIVE
To evaluate the clinical usefulness of the results obtained with (18)F-FDG PET/CT in relation to CT in the preoperative staging of patients with peritoneal carcinomatosis secondary to primary or recurrent ovarian cancer candidates to cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC).


METHODS
A retrospective study comparing the results obtained with CT and (18)F-FDG PET/CT in the preoperative evaluation of a series of 59 patients was performed. In all patients the peritoneal carcinomatosis index (PCI) was determined by preoperative radiological CT and 18F-FDG PET/CT and compared with surgical PCI, which was considered as reference.


RESULTS
Of the 59 patients studied, in 55 peritoneal carcinomatosis presences were confirmed (4 patients had complete responses to neoadjuvant chemotherapy). The mean surgical, CT and 18F-FDG PET/CT PCI was 9.46±7.70, 3.69±3.96 and 2.25±1.02, respectively. In the global disease detection, CT showed a higher positive likelihood ratio (LR+) than (18)F-FDG PET/CT (15.3, 95% CI 8.35-28.04 vs. 3.47, 95% CI 3.36-5.11) and a lower negative likelihood ratio (LR-) than 18F-FDG PET/CT (0.67, 95% CI 0.61-0.73 vs. 0.82, 95% CI 0.76-0.88). In every region of the abdomen the CT showed a greater LR+ than 18F-FDG PET/CT and a lower LR- than 18F-FDG PET/CT.


CONCLUSIONS
CT showed the best diagnostic results compared to (18)F-FDG PET/CT to confirme the presence of peritoneal disease. The lower performance of the (18)F-FDG PET/CT suggests that the main utility of (18)F-FDG PET/CT is to evaluate a possible metastatic extraperitoneal spread of the disease.
Peritoneal Carcinomatosis Unit, Surgery Department, Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
V
V
Lopez-Lopez
Peritoneal Carcinomatosis Unit, Surgery Department, Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain. Electronic address: cascalescirugia@gmail.com.
P A
PA
Cascales-Campos
Peritoneal Carcinomatosis Unit, Surgery Department, Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
J
J
Gil
Pet-ct Unit, Nuclear Medicine Department,Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
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L
Frutos
Radiology Department,Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
R J
RJ
Andrade
Radiology Department,Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
M
M
Fuster-Quiñonero
Oncology Department, Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
E
E
Feliciangeli
Peritoneal Carcinomatosis Unit, Surgery Department, Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
E
E
Gil
Peritoneal Carcinomatosis Unit, Surgery Department, Clinic and Universtiy Virgen de la Arrixaca Hospital, Murcia, Spain.
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P
Parrilla
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary; D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
18F-FDGPET/CT; CT-scan; HIPEC; Ovarian cancer; Peritoneal carcinomatosis