Enhanced computed tomography imaging features predict tumor grade in pseudomyxoma peritonei

Area of Science:

• Radiology
• Oncology
• Gastroenterology

Background:

• Pseudomyxoma peritonei (PMP) is a rare malignancy.
• Limited research exists on correlating computed tomography (CT) findings with PMP tumor grade.
• Abdominal enhanced CT may predict PMP tumor grade.

Purpose of the Study:

• To evaluate the predictive value of abdominal enhanced CT signs for differentiating high-grade from low-grade PMP.
• To identify specific CT features associated with PMP tumor grade.

Main Methods:

• Retrospective analysis of preoperative enhanced CT images from 75 PMP patients.
• Assessment of ascites, hepatic scalloping, omental/peritoneal lesions, calcification, septa, and organ involvement.
• Logistic regression and ROC curve analysis to determine the predictive utility of CT signs and their combination with CA125.

Main Results:

• Massive ascites and peritoneal solid nodules were significantly more frequent in high-grade PMP.
• These findings, along with thinner mucin deposition at hepatic scalloping (cutoff 18.6 mm), independently predicted high-grade PMP.
• Combining CT signs with cancer antigen 125 (CA125) improved high-grade PMP diagnosis (AUC 0.812 vs. 0.656).

Conclusions:

• CT signs of high-grade PMP differ significantly from low-grade PMP.
• Abdominal enhanced CT is valuable for PMP grading.
• Combining CT findings with CA125 offers enhanced classification accuracy for PMP.