title: PET/CT for differentiating between tuberculous peritonitis and peritoneal carcinomatosis: The parietal peritoneum.
abstract: OBJECTIVE
  Tuberculous peritonitis (TBP) mimics peritoneal carcinomatosis (PC). We aimed to investigate the discriminative use of PET/CT findings in the parietal peritoneum.
  
  
  METHODS
  Parietal peritoneal PET/CT findings from 76 patients with TBP (n = 25) and PC (n = 51) were retrospectively reviewed. The lesion locations were noted as right subdiaphragmatic, left subdiaphragmatic, right paracolic gutters, left paracolic gutters, and pelvic regions. The distribution characteristic consisted of a dominant distribution in the pelvic and/or right subdiaphragmatic region (susceptible area for peritoneal implantation, SAPI) (SAPI distribution), a dominant distribution in the remaining regions (less-susceptible area for peritoneal implantation, LSAPI) (LSAPI distribution), or a uniform distribution. PET morphological patterns were classified as F18-fluorodeoxyglucose (F-FDG) uptake in a long beaded line (string-of-beads F-FDG uptake) or in a cluster (clustered F-FDG uptake) or focal F-FDG uptake. CT patterns included smooth uniform thickening, irregular thickening, or nodules.
  
  
  RESULTS
  More common findings in the parietal peritoneum corresponding to TBP as opposed to PC were (a) ≥4 involved regions (80.0% vs 19.6%), (b) uniform distribution (72.0% vs 5.9%), (c) string-of-beads F-FDG uptake (76.0% vs 7.8%), and (d) smooth uniform thickening (60.0% vs 7.8%) (all P < 0.001), whereas more frequent findings in PC compared with TBP were (a) SAPI distribution (78.4% vs 28.0%), (b) clustered F-FDG uptake (56.9% vs 20.0%), (c) focal F-FDG uptake (21.6% vs 4.0%), (d) irregular thickening (51.0% vs 12.0%), and (e) nodules (21.6% vs 4.0%) (P < 0.001, P < 0.05, P > 0.05, P < 0.05, P > 0.05, respectively).
  
  
  CONCLUSIONS
  Our data show that PET/CT findings in the parietal peritoneum are useful for differentiating between TBP and PC.
authors.affiliation: aPET/CT Center, the First People's Hospital of Yunnan Province, Kunming bNanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou cDepartment of Radiology dDepartment of Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, China.
authors.forename: Shao-Bo
authors.initials: SB
authors.lastname: Wang
authors.forename: Yun-Hai
authors.initials: YH
authors.lastname: Ji
authors.forename: Hu-Bing
authors.initials: HB
authors.lastname: Wu
authors.forename: Quan-Shi
authors.initials: QS
authors.lastname: Wang
authors.forename: Wen-Lan
authors.initials: WL
authors.lastname: Zhou
authors.forename: Liang
authors.initials: L
authors.lastname: Lv
authors.forename: Tao
authors.initials: T
authors.lastname: Shou
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D010537:Peritoneum / Q000000981:diagnostic imaging* / Q000473:pathology; D014395:Peritonitis, Tuberculous / Q000000981:diagnostic imaging* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18