Advertisement

Abdominal Imaging

, Volume 33, Issue 1, pp 87–93 | Cite as

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

  • Clarisse DromainEmail author
  • Sophie Leboulleux
  • Anne Auperin
  • Diane Goere
  • David Malka
  • Jean Lumbroso
  • Martin Schumberger
  • Robert Sigal
  • Dominique Elias
Article

Abstract

Purpose

To assess and compare the performance of CT and 18F-FDG-PET/CT in the evaluation of peritoneal carcinomatosis (PC).

Method and materials

Thirty consecutive patients with PC and scheduled for a surgery underwent a CT of the abdomen and pelvis and a whole-body 18F-FDG PET/CT. The extent of PC was assessed precisely using the peritoneal cancer index combining the distribution of tumor throughout 11 abdominopelvic regions with a lesion size score. CT and PET/CT imaging results were compared in all patients with intraoperative findings using an interclass correlation test.

Results

The presence of PC was correctly determined on CT and PET/CT in 23/28 and 16/28 patients, respectively. The extent of PC was understaged with CT and PET/CT in 27 patients and overstaged with CT and PET/CT in 1 and 2 patients, respectively. The interclass correlation was 0.53 (moderate) between CT and surgery and 0.12 (low) between PET/CT and surgery. The interclass correlation was higher for mucinous tumor (0.63) than for non-mucinous (0.16) on CT imaging whereas no difference was found in PET/CT.

Conclusion

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.

Keywords

Peritoneal carcinomatosis FDG-PET Computed tomography Colorectal carcinoma Peritoneum CT Mucinous 

References

  1. 1.
    Elias D, Raynard B, Farkhondeh F, et al. (2006) Peritoneal carcinomatosis of colorectal origin. Gastroenterol Clin Biol 30:1200–1204PubMedCrossRefGoogle Scholar
  2. 2.
    Esquivel J, Sticca R, Sugarbaker P, et al. (2006) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Ann Surg Oncol, onlineGoogle Scholar
  3. 3.
    Glehen O, Kwiatkowski F, Sugarbaker PH, et al. (2004) Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. JCO 22:3284–3292CrossRefGoogle Scholar
  4. 4.
    Sugarbaker PH (1999) Management of peritoneal-surface malignancy: the surgeon’s role. Langenbeck’s Arch Surg 384:576–587CrossRefGoogle Scholar
  5. 5.
    Sugarbaker PH, Jablonski KA (1995) Prognostic features of 51 colorectal and 130 appendiceal cancer patients with peritoneal carcinomatosis treated by cytoreductive surgery and intraperitoneal chemotherapy. Ann Surg 221:124–132PubMedCrossRefGoogle Scholar
  6. 6.
    Jacquet P, Sugarbaker PH (1996) Clinical research methodologies in the diagnosis and staging of patients with peritoneal carcinomatosis. In: Sugarbaker PH (eds). Peritoneal Carcinomatosis: Principles of Management. Kluwer: Boston, p 370Google Scholar
  7. 7.
    Elias D, Benizri E, Vernerey D, et al. (2005) Preoperative criteria of incomplete resectability of peritoneal carcinomatosis from non-appendiceal colorectal carcinoma. Gastroenterol Clin Biol 29:1010–1013PubMedGoogle Scholar
  8. 8.
    De Bree E, Koops W, Kroger R, et al. (2004) Peritoneal carcinomatosis from colorectal or appendiceal origin: correlation of preoperative CT with intraoperative findings and evaluation of interobservers agreement. J Surg Oncol 86:64–73PubMedCrossRefGoogle Scholar
  9. 9.
    Jacquet P, Jelinek JS, Steves MA, et al. (1993) Evaluation of computed tomography in patients with peritoneal carcinomatosis. Cancer 72:1631–1636PubMedCrossRefGoogle Scholar
  10. 10.
    Warde P, Rideout DF, Herman S, et al. (1987) Computed tomography in advanced ovarian cancer: an evaluation of diagnostic accuracy. Am J Med Sci 293:94–98PubMedCrossRefGoogle Scholar
  11. 11.
    Coakley FV, Choi PH, Gougoutas CA, et al. (2002) Peritoneal metastases: detection with spiral CT in patients with ovarian cancer. Radiology 223:495–499PubMedCrossRefGoogle Scholar
  12. 12.
    Turlakow A, Yeung HW, Salmon AS, et al. (2003) Peritoneal carcinomatosis: role of 18F-FDG PET. J Nucl Med 44:1407–1412PubMedGoogle Scholar
  13. 13.
    Suzuki A, Kawano T, Takahashi N, et al. (2004) value of 18F-FDG PET in the detection of peritoneal carcinomatosis. Eur J Nucl Med Mol Imaging 31:1413–1420PubMedCrossRefGoogle Scholar
  14. 14.
    Tanaka T, Kawai Y, Kanai M, et al. (2002) Usefulness of FDG-positron emission tomography in diagnosing peritoneal recurrence of colorectal cancer. Am J Surg 184:433–436PubMedCrossRefGoogle Scholar
  15. 15.
    Rohren EM, Paulson EK, Hagge R, et al. (2002) The role of 18F FDG positron emission tomography in preoperative assessment of the liver in patients being considered for curative resection of hepatic metastases from colorectal cancer. Clin Nucl Med 27:550–555PubMedCrossRefGoogle Scholar
  16. 16.
    Sanchez Salmon A, Barandela Salgado J, Ruibal Morell A (2006) PET in abdominal pathology: advantages and limitations. Abdom Imaging 31:174–181PubMedCrossRefGoogle Scholar
  17. 17.
    Whiteford MH, Whiteford HM, Yee LF, et al. (2000) Usefulness of FDG-PET scan in the assessment of suspected metastatic or recurrent adenocarcinoma of the colon and the rectum. Dis Colon Rectum 43:767–770CrossRefGoogle Scholar
  18. 18.
    Higashi K, Ueda Y, Seki H, et al. (1998) Fluorine-18-FDG PET imaging is negative in bronchoalveolar lung carcinoma. J Nucl Med 39:1016–1020PubMedGoogle Scholar
  19. 19.
    Jacquet P, Jelinek JS, Chang D, et al. (1995) Abdominal computed tomographic scan in the selection of patients with mucinous peritoneal carcinomatosis for cytoreductive surgery. J Am Coll Surg 181:530–538PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Clarisse Dromain
    • 1
  • Sophie Leboulleux
    • 2
  • Anne Auperin
    • 3
  • Diane Goere
    • 4
  • David Malka
    • 5
  • Jean Lumbroso
    • 2
  • Martin Schumberger
    • 2
  • Robert Sigal
    • 1
  • Dominique Elias
    • 4
  1. 1.Department of RadiologyInstitut Gustave-RoussyVillejuif CedexFrance
  2. 2.Department of Nuclear medicineInstitut Gustave-RoussyVillejuif CedexFrance
  3. 3.Department of StatisticInstitut Gustave-RoussyVillejuif CedexFrance
  4. 4.Department of SurgeryInstitut Gustave-RoussyVillejuif CedexFrance
  5. 5.Department of MedicineInstitut Gustave-RoussyVillejuif CedexFrance

Personalised recommendations