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Value of 18F-FDG PET in the detection of peritoneal carcinomatosis

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Peritoneal carcinomatosis can be difficult to diagnose using computed tomography (CT). The purpose of this study was to evaluate the role of 2-(fluorine 18) fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the detection of peritoneal carcinomatosis.

Methods

We reviewed the CT and FDG PET radiological reports and clinical charts of 18 patients with peritoneal carcinomatosis and 17 cancer patients without peritoneal carcinomatosis. We also assessed FDG PET scans from 20 healthy volunteers as a baseline study. The maximum standardised uptake values (SUVmax) over peritoneal lesions in cancer patients and over the area of most intense intestinal uptake in healthy volunteers and cancer patients without peritoneal carcinomatosis were measured.

Results

The sensitivity and positive predictive value (PPV) of combined FDG PET and CT were superior to those of CT alone for the detection of peritoneal lesions (sensitivity: 66.7% vs 22.2%, p<0.025; PPV: 92.3% vs 50.0%, p<0.05). The most frequent pattern of FDG uptake in patients with peritoneal carcinomatosis was abnormally intense focal uptake near the abdominal wall. An SUVmax threshold of 5.1 produced a diagnostic accuracy of combined FDG PET and CT of 78%. The additional information provided by FDG PET allowed a more accurate diagnosis in 14 patients (40.0%), and led to alteration of the therapeutic strategy in five (14.3%) of the enrolled cancer patients.

Conclusion

We found that use of an intra-abdominal FDG uptake cut-off value for SUVmax of >5.1 assists in the diagnosis of peritoneal carcinomatosis. FDG PET may play an important role in the clinical management of patients with suspected peritoneal carcinomatosis.

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Acknowledgments

We thank Mr. T. Gibson for revising the text and Mr K. Hirono for his technical assistance.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa-ken, 236-0004, Japan

    Akiko Suzuki, Tsuyoshi Kawano, Nobukazu Takahashi, Jin Lee, Yoshihiro Nakagami & Tomio Inoue

  2. Department of Obstetrics and Gynecology, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa-ken, 236-0004, Japan

    Etsuko Miyagi & Fumiki Hirahara

  3. Department of Gastroenterological Surgery, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa-ken, 236-0004, Japan

    Shinji Togo & Hiroshi Shimada

Authors
  1. Akiko Suzuki
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  2. Tsuyoshi Kawano
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  3. Nobukazu Takahashi
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  4. Jin Lee
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  5. Yoshihiro Nakagami
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  6. Etsuko Miyagi
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  7. Fumiki Hirahara
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  8. Shinji Togo
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  9. Hiroshi Shimada
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  10. Tomio Inoue
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Corresponding author

Correspondence to Akiko Suzuki.

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Suzuki, A., Kawano, T., Takahashi, N. et al. Value of 18F-FDG PET in the detection of peritoneal carcinomatosis. Eur J Nucl Med Mol Imaging 31, 1413–1420 (2004). https://doi.org/10.1007/s00259-004-1577-y

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  • DOI: https://doi.org/10.1007/s00259-004-1577-y

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