64-Section multi-detector row CT in the preoperative diagnosis of peritoneal carcinomatosis: correlation with histopathological findings

Abstract

Background: To prospectively investigate the diagnostic accuracy of a 64-section multi-detector row computed tomography (CT) for the detection of peritoneal metastases, with the use of surgery and histopathological findings as the reference standard.

Methods: The study cohort comprised 18 patients with peritoneal carcinomatosis who underwent multiphasic CT with a 64-section CT, 0-119 days before cytoreductive surgery. Transverse CT images along with isotropic reformatted coronal and sagittal images were prospectively and independently evaluated by one of the five staff radiologists in an unblinded fashion.

Results: The overall sensitivity, specificity, positive, and negative predictive values of CT for the detection of peritoneal metastases were, respectively, 75% (93 of 124 lesions; confidence interval [CI] 68-84), 92% (118 of 128; CI 85-96), 90% (93 of 103; CI 83-95), and 79% (118 of 149; CI 72-86). For lesions 0.5 cm in diameter or larger, CT yielded a mean sensitivity of 89% (77 of 87; CI 75-97), although sensitivity decreased to only 43% (16 of 37; CI 28-56) for lesions <0.5 cm in diameter.

Conclusions: 64-Section CT with the addition of isotropic reformatted coronal and sagittal images is a very effective technique in the detection of peritoneal metastases of 0.5 cm in diameter or larger, although sensitivity decreases remarkably for lesions <0.5 cm in diameter.