Detection of histologically proven peritoneal carcinomatosis with fused 18F-FDG-PET/MDCT

Dirisamer, Albert; Schima, Wolfgang; Heinisch, Martin; Weber, Michael; Lehner, Hans Peter; Haller, Joerg; Langsteger, Werner

doi:10.1016/j.ejrad.2007.11.032

« Previous Next »European Journal of Radiology
Volume 69, Issue 3 , Pages 536-541, March 2009

Detection of histologically proven peritoneal carcinomatosis with fused 18F-FDG-PET/MDCT

Albert Dirisamer
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
- Corresponding author at: Department of Radiology, Medical University of Vienna, Austria. Tel.: +43 1 40400 4893; fax: +43 1 40400 4894.
Wolfgang Schima
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
Martin Heinisch
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria
Michael Weber
- Department of Radiology, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
Hans Peter Lehner
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria
Joerg Haller
- Department of Radiology, Hanusch Krankenhaus, Heinrich-Collin-Strasse 30, 1140 Vienna, Austria
Werner Langsteger
- Department of Nuclear Medicine, St. Vincent's Hospital, Seilerstaette 4, 4010 Linz, Austria

Received 11 September 2007; accepted 19 November 2007.

Abstract

Objective

To evaluate peritoneal carcinomatosis in patients with gastrointestinal and gynecologic malignancies and to assess the diagnostic role for 18-FDG-PET and MDCT alone in comparison to the diagnostic accuracy of fused 18F-FDG-PET/MDCT by using surgical and histopathological findings as the standard of reference.

Methods and subjects

Sixty-two patients (13 males, 49 females; age range 43–81; mean age, 62 years with suspected peritoneal carcinomatosis were reviewed for the presence of peritoneal lesions on 18F-FDG-PET/MDCT scans (Discovery LS, GE Medical Systems). The results were compared with the histological findings at laparatomy. Thirty-one patients had peritoneal metastases, while 31 patients had negative histological findings at laparotomy.

Results

CT detected peritoneal seeding in 26/31 patients, 18F-FDG-PET in 25/31 patients, and 18F-FDG-PET/MDCT in 30/31 patients, for a sensitivity of 88%, 88%, and 100%, respectively. False-positive findings were seen in MDCT in one patient, in 18F-FDG-PET in two patients, and in 18F-MDCT-PET/MDCT in one patient, for a specificity of 97%, 94%, and 97%, respectively.

Conclusion

Fused 18F-FDG-PET/MDCT is superior to MDCT and 18F-FDG-PET alone for the detection of peritoneal carcinomatosis especially in small lesions and it offers exact anatomic information for surgical treatment.

Keywords: PET/CT, Peritoneal carcinomatosis, 18F-FDG