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Evaluation of computed tomography in patients with peritoneal carcinomatosis
Author(s) -
Jacquet Pierre,
Jelinek James S.,
Steves Mark A.,
Sugarbaker Paul H.
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930901)72:5<1631::aid-cncr2820720523>3.0.co;2-i
Subject(s) - medicine , pelvis , abdomen , exploratory laparotomy , radiology , laparotomy , malignancy , peritoneal carcinomatosis , nuclear medicine , nodule (geology) , computed tomography , carcinosis , flank , tomography , cancer , colorectal cancer , surgery , pathology , anatomy , paleontology , biology
Background . Radiologic tests to determine the size and location of cancer on peritoneal surfaces are needed for patient management and for clinical research activity. Methods . Computed tomography (CT) of the abdomen and pelvis were obtained on 45 patients with a diagnosis of peritoneal carcinomatosis before implementation of a complete exploratory laparotomy with biopsy or resection of all tissues suspicious of malignancy. CT findings and surgical findings were recorded and the data analyzed by dividing the abdomen into 9 regions or into 15 anatomic sites. Results . In an overall patient analysis, the sensitivity was 79%. In the nine different abdominal regions, sensitivity was greater than 80% in the right flank, left flank, and right lower and left lower abdominal regions. Sensitivity was lowest in the pelvis (60%). Negative predictive value in the pelvis was 20%. The volume of tumor present within an abdominal region or anatomic site greatly influenced the sensitivity. A sensitivity of only 28% was recorded when tumor nodules were less than 0.5 cm in thickness. This increased to 90% when nodule thickness was greater than 5 cm. Conclusions . CT is not a reliable diagnostic test for low volume tumor on peritoneal surfaces, and the greatest inaccuracies were recorded in the pelvis. Its diagnostic value increased as tumor volume increased.