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

Michael Soussan1, Gaëtan Des Guetz, Vincent Barrau

  • 1Department of Nuclear Medicine, Université Paris 13, CHU Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France. michael.soussan@avc.aphp.fr

European Radiology
|February 24, 2012
PubMed
Abstract

Insights

Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and magnetic resonance imaging with diffusion-weighted imaging (MR-DWI) demonstrate comparable accuracy for diagnosing peritoneal carcinomatosis (PC). Both methods exhibit reduced sensitivity for subcentimeter lesions, potentially underestimating the full extent of PC.

Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Peritoneal carcinomatosis (PC) is a common complication of gastrointestinal malignancies.
  • Accurate diagnosis and staging of PC are crucial for treatment planning and patient outcomes.
  • Conventional imaging modalities may have limitations in detecting small peritoneal implants.

Purpose of the Study:

  • To evaluate and compare the diagnostic accuracy of FDG-PET/CT and MR-DWI for detecting PC in patients with gastrointestinal cancers.
  • To assess the performance of these imaging techniques in different regions of the peritoneal cavity.
  • To determine the sensitivity of each modality for detecting subcentimeter lesions.

Main Methods:

  • A retrospective study involving 30 consecutive patients with gastrointestinal malignancy undergoing both FDG-PET/CT and MR-DWI.
  • The peritoneal cavity was divided into three sites for analysis (supramesocolic and inframesocolic).
  • Diagnosis confirmation was achieved through surgical assessment or follow-up imaging.

Main Results:

  • FDG-PET/CT showed 80% accuracy (patient-based) and MR-DWI showed 83% accuracy.
  • On a site-based analysis, MR-DWI demonstrated higher sensitivity (74%) and specificity (97%) compared to FDG-PET/CT (63%, 90%).
  • Both techniques had lower sensitivity for subcentimeter implants (42% for PET/CT, 50% for MR-DWI).

Conclusions:

  • FDG-PET/CT and MR-DWI exhibit similar high accuracy in diagnosing peritoneal carcinomatosis.
  • MR-DWI may offer superior detection in the supramesocolic region.
  • Both imaging modalities are limited in detecting small peritoneal lesions, necessitating careful interpretation.

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