Diagnostic value of positron emission tomography/computed tomography (PET/CT) in detection of peritoneal carcinomatosis

Abstract

Background The diagnosis of peritoneal carcinomatosis is challenging and can be difficult to detect with imaging, especially the detection of small-sized peritoneal lesions. The presence of peritoneal neoplastic spread alters tumour staging and is one of the most significant prognostic indicators in several malignancies, and the purpose of this study was to highlight the diagnostic value of PET/CT in detection of peritoneal carcinomatosis in patients with malignant neoplastic disease. Results PET/CT has 76.2% sensitivity, 88.9% specificity, 94.1% PPV, 61.5% NPV and 80% accuracy in detection of peritoneal carcinomatosis. Different patterns of FDG uptake of peritoneal carcinomatosis were found such as focal nodular uptake, diffuse abdominal uptake and liver surface focal or diffuse uptake. From all these different patterns, focal nodular uptake was the most frequent pattern. The best cut-off value of SUVmax was 5 for diagnosis. Conclusions The study affirms the significant role of PET/CT in the diagnosis of peritoneal carcinomatosis and its important value in the staging, management and follow-up of patients with secondary peritoneal malignancies, especially in case of unavailable or inappropriate peritoneal biopsy. Therefore, PET/CT could help reduce the number of laparotomies and a better selection of patients who are candidates for adjuvant chemotherapy.