Unveiling the Metabolic Maze: FDG PET/CT Findings in Peritoneal Carcinomatosis - A Case Series

Peritoneal carcinomatosis (PC), the spread of cancer cells in the peritoneum, is a significant concern in advanced gastrointestinal and gynecological cancers. This case series includes findings on the appearance and pattern of PC on ¹⁸F-fluorodeoxyglucose positron emission tomography/CT (¹⁸F-FDG PET/CT). The primary sources of peritoneal dissemination are direct invasion from abdominal or pelvic tumors and metastatic spread from distant tumors. The accurate preoperative diagnosis and quantification of PC play a vital role in determining the appropriate treatment approach, with a particular emphasis on surgical planning. Several imaging modalities have been employed in preoperative evaluation, such as computed tomography (CT), magnetic resonance imaging (MRI), and ¹⁸F-FDG PET/CT. Among these modalities, ¹⁸F-FDG PET/CT has demonstrated improved anatomical localization and accurate information about the nature of pathological findings. The case series showcases four cases that illustrate the imaging characteristics of PC on FDG PET/CT. FDG PET/CT plays a vital role in diagnosing and assessing PC, aiding in its detection, staging, and treatment planning. It surpasses conventional imaging techniques in identifying and characterizing lesions and detecting the primary tumor site in cases where its location is unknown. Furthermore, FDG PET/CT additionally assists in evaluating treatment response and monitoring disease progression, providing insights into treatment effectiveness and guiding patient management decisions.