Role of Imaging in Peritoneal Surface Malignancies

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Peritoneal metastases (PM) significantly impact cancer staging, treatment decisions, and patient prognosis.
• Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) offers improved survival for select PM patients.
• Early diagnosis of peritoneal tumor seeding is critical for optimizing treatment outcomes.

Purpose of the Study:

• To review the role of various imaging modalities in the management of peritoneal malignancies.
• To highlight the importance of imaging in patient selection for CRS and HIPEC.
• To discuss the utility of different imaging techniques in assessing the extent of peritoneal disease.

Main Methods:

• Review of current literature on imaging modalities for peritoneal malignancies.
• Discussion of the application of Multidetector CT (MDCT), MRI, and PET-CT in PM evaluation.
• Focus on imaging's role throughout the treatment pathway, particularly for CRS and HIPEC.

Main Results:

• Multidetector CT (MDCT) is the primary imaging modality due to its availability, speed, and resolution for assessing PM extent.
• MRI is less utilized due to practical limitations, while PET-CT aids in detecting extra-peritoneal disease.
• Accurate staging through imaging is essential for successful CRS and HIPEC outcomes.

Conclusions:

• Imaging is indispensable for evaluating peritoneal malignancies and guiding treatment strategies.
• MDCT remains the cornerstone for assessing peritoneal tumor burden and selecting patients for CRS and HIPEC.
• Continued advancements in imaging are vital for improving the management and outcomes of patients with peritoneal metastases.