Induced pueumoperitoneum in CT evaluation of peritoneal carcinomatosis

Abstract

With CT-PP there seems to be a reduction in the threshold of detectability of peritoneal implants. The direct demonstration of intraperitoneal adhesions is an important secondary finding. Disadvantages of CT-PP are (1) it is a time-consuming method and (2) it does not evaluate all the peritoneal recesses potentially involved in peritoneal carcinomatosis.

Peritoneal carcinomatosis from colorectal or appendiceal origin: Correlation of preoperative CT with intraoperative findings and evaluation of interobserver agreement

“…Contrarily, in patients with peritoneal carcinomatosis from colonic or appendiceal origin no significant difference was observed between this technique and standard CT [38]. Caseiro-Alves et al [39] examined the sensitivity in detection of peritoneal implants by CT after induced pneumoperitoneum in five ovarian cancer patients. With this technique there seemed to be a reduction in the threshold of detectability of peritoneal nodules in some areas.…”

Peritoneal metastases in children with cancer

“…Noninvasive identification of peritoneal metastases has improved considerably with the advent of CT 11, 14, 28. However, the detection of peritoneal implants is limited by the lesion size,11, 29 paucity of intraabdominal fat, contiguity with the primary tumor,28 presence or absence of ascites, implant location,30 and adequacy of bowel opacification. Current CT scanners are able to detect approximately 50% of surgically proven peritoneal implants as small as 5 mm 11, 14.…”

Detection of Peritoneal Metastases

“…CT is considered the best imaging procedure for the evaluation of patients with known or suspected peritoneal metastases. The use of intraperitoneal positive contrast and pneumoperitoneum with CT has been suggested to improve the detection of small peritoneal metastases but these techniques do not routinely opacify all the peritoneal recesses[ 2 – 4 ]. These methods are more interventional and time consuming and consequently are not widely used.…”