Staging of peritoneal carcinomatosis: enhanced CT vs. PET/CT

Abstract

The intraperitoneal assessment of the extent of carcinomatosis, necessary to assess prognosis and treatment planning, is not accurate enough with CT and PET/CT imaging.

Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal carcinomatosis?

“…Recurrences in the adrenal bed, stuck to the peritoneum, were classified as local recurrences. PC on FDG-PET/CT was suspected in cases of intense peritoneal focal uptake, nodular or curvilinear uptake along the liver or left subphrenic space (23). All PC diagnosed on FDG-PET were confirmed on a subsequent guided TAP-CT. All PC diagnosed on CT and on FDG-PET/CT were confirmed by one experienced radiologist and one experienced nuclear medicine physician respectively.…”

“…PC was diagnosed on postoperative CT in case of parietal peritoneal thickening, parietal peritoneal enhancement, and enhancing nodules (23). Recurrences in the adrenal bed, stuck to the peritoneum, were classified as local recurrences.…”

Cytoreductive Surgery and Peritonectomy Procedures

“…PET or PET-CT scans may add some more information in this direction by detecting extraabdominal (mediastinal or supraclavicular) lymphadenopathy. However, regarding evaluation of peritoneal disease volume and distribution, PET or PET-CT scans does not give additional information compared with a regular, good-quality CT scan [29]. For mucinous carcinomatosis, CT scan with two distinctive radiologic criteria (segmental obstruction of the small bowel and presence of tumor nodules greater than 5 cm in diameter on small bowel surfaces or directly adjacent to small bowel mesentery) may distinguish patients with resectable disease from those with non-resectable malignancy.…”

Role of Imaging in Peritoneal Surface Malignancies

“…[72,73] Both techniques provide morphological information enabling detection of peritoneal masses, nodules, ascites. For all imaging techniques, exact information regarding the extent and localization of the extent and localization of PC is mandatory [74]. Differentiation between scar tissue due to previous surgery and the identification of micro nodular pc without tumor masses is challenging for imaging techniques mainly relying on morphology.…”