European Radiology

, Volume 22, Issue 7, pp 1479–1487 | Cite as

Comparison of FDG-PET/CT and MR with diffusion-weighted imaging for assessing peritoneal carcinomatosis from gastrointestinal malignancy

  • Michael SoussanEmail author
  • Gaëtan Des Guetz
  • Vincent Barrau
  • Vanessa Aflalo-Hazan
  • Gabriel Pop
  • Ziad Mehanna
  • Edmond Rust
  • Thomas Aparicio
  • Richard Douard
  • Robert Benamouzig
  • Philippe Wind
  • Véronique Eder



To assess the accuracy of FDG-PET/CT and MR with diffusion-weighted imaging (MR-DWI) for diagnosing peritoneal carcinomatosis (PC) from gastrointestinal malignancies.


Thirty consecutive patients referred for staging of gastrointestinal malignancy underwent FDG-PET/CT and MR-DWI in this retrospective study. Extent of PC was characterised by dividing the peritoneal cavity into three sites in each patient: right and left supramesocolic areas and inframesocolic level (total 90 sites). Presence of PC was confirmed either by surgery (18/30) or by follow-up (12/30).


PC was confirmed in 19 patients (19/30). At a total of 90 sites, 27 showed proven PC. On a patient-based analysis, sensitivity, specificity, PPV, NPV and accuracy were respectively 84%, 73%, 84%, 73% and 80% for PET/CT and 84%, 82%, 89%, 75% and 83% for MR-DWI. On a site-based analysis, overall sensitivity and specificity of PET/CT (63%, 90%) and MR-DWI (74%, 97%) were not statistically different (P = 0.27). In the supramesocolic area, MR-DWI detected more sites involved than PET/CT (7/9 vs. 4/9). The sensitivities of PET and MR were lower for subcentimetre tumour implants (42%, 50%). Interobserver agreement was very good for PET/CT and good for MR-DWI.


FDG-PET/CT and MR-DWI showed similar high accuracy in diagnosing PC. Both techniques underestimated the real extent of PC because of decreased sensitivity for subcentimetre lesions.

Key Points

FDG-PET/CT and MR-DWI showed similar high accuracy for diagnosing peritoneal carcinomatosis.

In the supramesocolic area, MR-DWI could be more sensitive than PET/CT.

Both techniques showed lower sensitivity for subcentimetre lesions.

Interobserver agreement was very good for PET/CT and good for MR-DWI.


Peritoneal carcinomatosis FDG-PET/CT MRI Diffusion-weighted imaging Gastrointestinal malignancy 



We are indebted to Dr Bernard Uzzan, who carefully reviewed the manuscript.


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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Michael Soussan
    • 1
    • 7
    Email author
  • Gaëtan Des Guetz
    • 2
  • Vincent Barrau
    • 3
  • Vanessa Aflalo-Hazan
    • 4
  • Gabriel Pop
    • 1
  • Ziad Mehanna
    • 5
  • Edmond Rust
    • 6
  • Thomas Aparicio
    • 7
  • Richard Douard
    • 5
  • Robert Benamouzig
    • 7
  • Philippe Wind
    • 5
  • Véronique Eder
    • 1
  1. 1.Department of Nuclear MedicineUniversité Paris 13BobignyFrance
  2. 2.Department of OncologyUniversité Paris 13BobignyFrance
  3. 3.Department of RadiologyCentre Cardiologique du NordSaint DenisFrance
  4. 4.Department of RadiologyUniversité Paris 13BobignyFrance
  5. 5.Department of Digestive SurgeryUniversité Paris 13BobignyFrance
  6. 6.Department of Nuclear Medicine, CHU HautepierreStrasbourgFrance
  7. 7.Department of Gastroenterology and HepatologyUniversité Paris 13BobignyFrance

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