Learning objectives
Review the spectrum of CT features of peritoneal carcinomatosis and its mimics.
Discuss the potential role of PET-CT in evaluating patients with peritoneal metastasis.
Background
Definition
Peritoneal carcinomatosis is the most common malignant process in the peritoneal cavity,
defined as seeding and implantation of neoplastic cells in the peritoneum originating from several abdominopelvic primary malignancies,
namely carcinomas of gastrointestinal tract and ovary.
The presence of peritoneal carcinomatosis alters tumor staging,
with direct implications in treatment choice and prognosis.
Therefore,
early diagnosis of peritoneal tumor seeding is fundamental,
as is the assessment of its extent and distribution.
Anatomic Spaces,
Fluid Flow and Pathways of Spread in the Peritoneal Cavity
The peritoneal...
Imaging findings OR Procedure details
The role of imaging is to establish the diagnosis and assist with the management of the disease,
namely in surgical planning.
Imaging can identify the primary tumors and can assess the location of the metastatic process (e.g.
identify if there is supramesocolic and/or inframesocolic involvement,
if there are signs of mesentery and omentum metastasis,
etc).
There are various patterns of peritoneal involvement and their knowledge allows the correct diagnosis.
Location:
The main sites of growth of seeded metastasis follow the pathways of ascitic flow and...
Conclusion
CT scan plays an important role in the detection of peritoneal carcinomatosis and its mimics.
However,
the exact diagnosis and characterization of lesions may be difficult due to the overlap of imaging findings.
CT scan can also play an important role in guiding biopsy for tissue diagnosis and can provide the surgeon with a ‘road map’ prior to cytoreductive surgery.
PET-CT scanners offer the combined benefits of anatomic and functional imaging,
improving lesion localization and resulting in significant diagnostic improvement.
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