Berthelot Cécile, Morel Olivier, Girault Sylvie, Verrièle Véronique, Poirier Anne-Lise, Moroch Julien, Boucher Yvan, Le Jeune Jean-Jacques, Lorimier Gérard
Department of aNuclear Medicine, University Hospital, Angers, France.
Nucl Med Commun. 2011 Jan;32(1):23-9. doi: 10.1097/MNM.0b013e328340e730.
Peritoneal carcinomatosis (PC) is associated with a very poor prognosis. Complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy has been shown to improve survival rates of PC. However, this treatment is beneficial for patients if the complete cytoreductive surgery is macroscopically completed before implementing hyperthermic intraperitoneal chemotherapy. Even so, a strict selection of patients is of fundamental importance because of the invasive nature of the intervention. The aim of this study was to assess the performance of FDG-PET/CT examinations for the diagnosis and evaluation of the extent of PC.
A retrospective analysis was conducted on 28 consecutive patients with suspected PC, scheduled for a complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, and who underwent an FDG-PET/CT examination. We compared the results of PET examinations with histological and intraoperative findings. The extent of PC was assessed precisely using a simplified 'peritoneal cancer index', within the three modalities (PET, surgery and histology).
Of 28 patients, 23 had histological PC. The sensitivity and specificity of the PET examination for the diagnosis of PC were, respectively, 82 and 100%. Even if the extent of PC was underestimated by PET, there was a good correlation when compared with histology and intraoperative results.
PET presented a good performance level in the diagnosis and evaluation of the extent of PC. PET/CT examinations could be useful to avoid unnecessary surgery.
腹膜癌病（PC）的预后很差。已证明完全细胞减灭术联合腹腔内热化疗可提高PC患者的生存率。然而，只有在实施腹腔内热化疗之前宏观上完成完全细胞减灭术，这种治疗对患者才有益。即便如此，由于该干预措施具有侵入性，严格选择患者至关重要。本研究的目的是评估FDG-PET/CT检查在PC诊断及评估其范围方面的性能。
对连续28例疑似PC的患者进行回顾性分析，这些患者计划接受完全细胞减灭术和腹腔内热化疗，并接受了FDG-PET/CT检查。我们将PET检查结果与组织学和术中发现进行了比较。在PET、手术和组织学这三种检查方式中，使用简化的“腹膜癌指数”精确评估PC的范围。
28例患者中，23例有组织学证实的PC。PET检查诊断PC的敏感性和特异性分别为82%和100%。即使PET对PC范围的评估偏低，但与组织学和术中结果相比仍有良好的相关性。
PET在PC诊断及评估其范围方面表现出良好的性能水平。PET/CT检查可能有助于避免不必要的手术。
