Intraperitoneal contrast material improves the CT detection of peritoneal metastases.

Halvorsen, Robert A.; Panushka, C; Oakley, G J; Letourneau, J G; Adcock, Leon L.

doi:10.2214/ajr.157.1.2048534

Cited by 54 publications

(31 citation statements)

References 4 publications

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“…Interactive review on a workstation can be used to distinguish bowel from implants. Axial oblique and coronal images can be used to evaluate the region of the uterosacral ligaments and pelvic sidewall, as has been described previously [10,13].…”

Section: Discussionmentioning

confidence: 99%

Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer

Chandrashekhara

Thulkar²,

Srivastava³

et al. 2011

BJR

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Objective: In the management of epithelial ovarian cancer (EOC), the identification of peritoneal deposits is the most important prognostic factor. We conducted a prospective study to evaluate the role of multidetector CT (MDCT) in identifying peritoneal deposits pre-operatively. Methods: 38 previously untreated patients (median age 50 years; range 26-70 years) were evaluated with contrast-enhanced MDCT of the abdomen and pelvis. All CT scans were performed on a four-slice MDCT scanner with thin-slice image acquisition. Multiplanar coronal, sagittal or oblique images were constructed and all images were reviewed by at least two radiologists. The extent of disease was determined and mapped for all areas of the abdomen and pelvis. CT scans were reviewed and compared with surgical findings. Peritoneal deposits and thickening were separately noted for each of the nine segments of the abdomen and pelvis (i.e. bilateral hypochondria, bilateral lumbar, bilateral iliac fossa, epigastrium, umbilical region and hypogastrium) and were mainly used to determine the accuracy of MDCT in the depiction of peritoneal carcinomatosis. Results: Sensitivity, specificity, positive and negative predictive values and accuracy of CT in the detection of peritoneal deposits were similar to those reported in the literature. The most common anatomical sites to have peritoneal deposits were the pouch of Douglas (18 cases) and the right subdiaphragmatic region (18 cases). Conclusion: Despite the improved scanning technology, image reconstruction and viewing ability of MDCT, its overall accuracy for the detection of peritoneal deposits is not significantly improved when compared with conventional CT; however, MDCT is useful in the assessment of disease at specific locations in the abdomen and pelvis.

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Section: Discussionmentioning

confidence: 99%

Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer

Chandrashekhara

Thulkar²,

Srivastava³

et al. 2011

BJR

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“…CT with intraperitoneal contrast media was initially used to study fluid dynamics and subsequently applied to the detection of peritoneal metastases. In ovarian cancer patients, intraperitoneal administration of contrast material seems to improve the sensitivity of CT in preoperative detection of these lesions [34][35][36][37]. However, this technique failed to detect flat peritoneal metastases, and had a low specificity in patients with a history of prior abdominal surgery [34].…”

Section: Discussionmentioning

confidence: 99%

“…In ovarian cancer patients, intraperitoneal administration of contrast material seems to improve the sensitivity of CT in preoperative detection of these lesions [34][35][36][37]. However, this technique failed to detect flat peritoneal metastases, and had a low specificity in patients with a history of prior abdominal surgery [34]. Contrarily, in patients with peritoneal carcinomatosis from colonic or appendiceal origin no significant difference was observed between this technique and standard CT [38].…”

Section: Discussionmentioning

confidence: 99%

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

Bree

Koops

Kröger

et al. 2004

Journal of Surgical Oncology

253

135

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“…Current CT scanners can detect 50% of peritoneal implants as small as 5 mm [9]. The use of intraperitoneal contrast has been suggested to increase detection of peritoneal tumor implants smaller than 5 mm and has been found to increase detection up to 2 -4 times that of standard exams [10].…”

Section: Staging Of Ovarian Carcinomamentioning

confidence: 99%

“…Visualization of peritoneal implants is improved with administration of intravenous contrast and use of intraperitoneal contrast has been recommended as well [9,10].…”

mentioning

confidence: 99%

CT and MRI of ovarian cancer

1995

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Among the gynecologic malignancies, ovarian cancer is second most common in incidence. However, unlike the other gynecologic cancers, its mortality has decreased only minimally during the last two decades [1]. Only recently, preliminary studies suggest promising results for ovarian cancer screening using transvaginal ultrasound in combination with serum Ca 125 levels [22,23]. Exploratory laparotomy has been the mainstay in the management of ovarian cancer, as it offers histopathological evaluation as well as cytoreduction. However, it is limited by its inaccuracy with understaging in 30-40% at initial presentation. Cross-sectional imaging contributes valuable information toward preoperative surgical and management planning. The proper surgical approach can be selected, the need for preoperative chemotherapeutic debulking can be assessed, and the surgeon will be forewarned of the need for assistance from a gynecologic oncologic surgeon or gastrointestinal oncologic surgeon if a complicated surgical procedure or bowel resection is indicated. CT is established as the primary imaging modality for characterization of ovarian tumors and ovarian cancer staging, while MR is emerging as a problem-solving modality. MR seems to be superior to CT in lesion characterization, in evaluation of local extent of tumor, and in tumor implants involving the hemidiaphragm and liver surface. The role of spiral CT has yet to be explored.

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Intraperitoneal contrast material improves the CT detection of peritoneal metastases.

Cited by 54 publications

References 4 publications

Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer

Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer

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

CT and MRI of ovarian cancer

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