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. 2023 Dec;48(12):3634-3642.
doi: 10.1007/s00261-022-03703-1. Epub 2022 Oct 29.

FDG-PET/MRI for the preoperative diagnosis and staging of peritoneal carcinomatosis: a prospective multireader pilot study

Naik Vietti Violi  1   2 , Somali Gavane  3 , Pamela Argiriadi  3 , Amy Law  3 , Sherif Heiba  3 , Eliahu Y Bekhor  4 , James S Babb  5 , Munir Ghesani  3 , Daniel M Labow  6 , Bachir Taouli  7   8
Affiliations

FDG-PET/MRI for the preoperative diagnosis and staging of peritoneal carcinomatosis: a prospective multireader pilot study

Naik Vietti Violi et al. Abdom Radiol (NY). 2023 Dec.

Abstract

Purpose: To assess the diagnostic performance of FDG-PET/MRI for the preoperative diagnosis and staging of peritoneal carcinomatosis (PC) using surgical Sugarbaker's PC index (PCI) as the reference in a multireader pilot study.

Methods: Fourteen adult patients (M/F: 3/11, mean age: 57 ± 12 year) with PC were prospectively included in this single-center study. Patients underwent FDG-PET/MRI prior to surgery (mean delay: 14 d, range: 1-63 d). Images were reviewed independently by 2 abdominal radiologists and 2 nuclear medicine physicians. The radiologists assessed contrast-enhanced abdominal MR images, while the nuclear medicine physicians assessed PET images fused with T2-weighted images. The abdomen was divided in 13 regions, scored from 0 to 3. A hybrid FDG-PET/MRI radiological PCI was created by combining the study data. Radiological PCI was compared to the surgical PCI on a per-patient and per-region basis. Inter-reader agreement was evaluated.

Results: Mean surgical PCI was 10 ± 8 (range: 0-24). Inter-reader agreement was almost perfect for all sets for radiologic PCI (Kappa: 0.81-0.98). PCI scores for all reading sets significantly correlated with the surgical PCI score (r range: 0.57-0.74, p range: < 0.001-0.003). Pooled per-patient sensitivity, specificity, and accuracy were 75%/50%/71.4% for MRI, 66.7%/50%/64.3% for FDG-PET, and 91.7%/50%/85.7% for FDG-PET/MRI, without significant difference (p value range 0.13-1). FDG-PET/MRI achieved 100% sensitivity and 100% specificity for a cutoff PCI of 20. Per-region sensitivity and accuracy were lower: 37%/61.8% for MRI, 17.8%/64.3% for FDG-PET, and 52.7%/60.4% for FDG-PET/MRI, with significantly higher sensitivity for FDG-PET/MRI. Per-region specificity was higher for FDG-PET (95%) compared to MRI (78.4%) and FDG-PET/MRI (66.5%).

Conclusion: FDG-PET/MRI achieved an excellent diagnostic accuracy per-patient and weaker performance per-region for detection of PC. The added value of PET/MRI compared to MRI and FDG-PET remains to be determined.

Keywords: Diffusion; FDG; MRI; PET; Peritoneal carcinomatosis.

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References

    1. Coccolini F, Gheza F, Lotti M, Virzi S, Iusco D, Ghermandi C, Melotti R, Baiocchi G, Giulini SM, Ansaloni L, Catena F (2013) Peritoneal carcinomatosis. World J Gastroenterol 19 (41):6979-6994. doi: https://doi.org/10.3748/wjg.v19.i41.6979 - DOI - PubMed - PMC
    1. Glehen O, Mithieux F, Osinsky D, Beaujard AC, Freyer G, Guertsch P, Francois Y, Peyrat P, Panteix G, Vignal J, Gilly FN (2003) Surgery combined with peritonectomy procedures and intraperitoneal chemohyperthermia in abdominal cancers with peritoneal carcinomatosis: a phase II study. J Clin Oncol 21 (5):799-806. doi: https://doi.org/10.1200/JCO.2003.06.139 - DOI - PubMed
    1. Sugarbaker PH (2003) Carcinomatosis--is cure an option? J Clin Oncol 21 (5):762-764. doi: https://doi.org/10.1200/JCO.2003.12.071 - DOI - PubMed
    1. Verwaal VJ, van Ruth S, de Bree E, van Sloothen GW, van Tinteren H, Boot H, Zoetmulder FA (2003) Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol 21 (20):3737-3743. doi: https://doi.org/10.1200/JCO.2003.04.187 - DOI - PubMed
    1. Elias D, Blot F, El Otmany A, Antoun S, Lasser P, Boige V, Rougier P, Ducreux M (2001) Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy. Cancer 92 (1):71-76. doi: https://doi.org/10.1002/1097-0142(20010701)92:1<71::aid-cncr1293>3... - DOI - PubMed

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