Use of 18F-FDG PET/CT in the preoperative evaluation of patients diagnosed with peritoneal carcinomatosis of ovarian origin, candidates to cytoreduction and hipec. A pending issue. Issue 10 (October 2016)

• Record Type: Journal Article
• Authors: Lopez-Lopez, V.; Cascales-Campos, P.A.; Gil, J.; Frutos, L.; Andrade, R.J.; Fuster-Quiñonero, M.; Feliciangeli, E.; Gil, E.; Parrilla, P.
• Is Part Of: European journal of radiology. Volume 85:Issue 10(2016)
• Page Start: 1824
• Page End: 1828
• Publication Date: 2016-10
• Subjects: 18F-FDGPET/CT -- CT-scan -- Peritoneal carcinomatosis -- Ovarian cancer -- HIPEC; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.08.006
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: CT showed the better results confirming ovarian peritoneal disease than 18 F-FDG PET/CT. CT and 18 F-FDG PET/CT present a low detection capability for LSS-3 injury. Main utility of 18 F-FDG PET/CT is the evaluation of extraperitoneal extension. Abstract: Purpose: To evaluate the clinical usefulness of the results obtained with 18 F-FDG PET/CT in relation to CT in the preoperative staging of patients with peritoneal carcinomatosis secondary to primary or recurrent ovarian cancer candidates to cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC). Material and methods: A retrospective study comparing the results obtained with CT and 18 F-FDG PET/CT in the preoperative evaluation of a series of 59 patients was performed. In all patients the peritoneal carcinomatosis index (PCI) was determined by preoperative radiological CT and 18F-FDG PET/CT and compared with surgical PCI, which was considered as reference. Results: Of the 59 patients studied, in 55 peritoneal carcinomatosis presences were confirmed (4 patients had complete responses to neoadjuvant chemotherapy). The mean surgical, CT and 18F-FDG PET/CT PCI was 9.46 ± 7.70, 3.69 ± 3.96 and 2.25 ± 1.02, respectively. In the global disease detection, CT showed a higher positive likelihood ratio (LR+) than 18 F-FDG PET/CT (15.3, 95% CI 8.35–28.04 vs. 3.47, 95% CI 3.36–5.11) and a lower negative likelihood ratio (LR-) than 18F-FDG PET/CT (0.67, 95% CI 0.61–0.73 vs. 0.82, 95% CI 0.76–0.88). In every region of the abdomen the CT showed a greater LR+ than 18F-FDG PET/CT and a lower LR- than 18F-FDG PET/CT. Conclusions: CT showed the best diagnostic results compared to 18 F-FDG PET/CT to confirme the presence of peritoneal disease. The lower performance of the 18 F-FDG PET/CT suggests that the main utility of 18 F-FDG PET/CT is to evaluate a possible metastatic extraperitoneal spread of the disease.