Contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC): methodological issues on diagnostic value and reliability

Excerpt

We were interested to read the paper by Sommariva A and colleagues published in the May 2018 issue of the Abdom Radiol (NY) [1]. The purpose of the authors was to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). They included 27 patients with different types of peritoneal carcinomatosis candidates to CS + HIPEC who underwent FDG PET/ceCT in a single session. Two nuclear medicine physicians and two radiologists independently and blindly evaluated PET/CT and ceCT imaging, respectively. Based on their results, the coefficient of correlation between PCI of PET/CT and surgery was 0.528, while it resulted higher between PET/ceCT and surgery (r = 0.878), very similar to ceCT and surgery (r = 0.876). They also reported that PET/CT had clearly high specificities (range 71%–100%) for each segment, except for the segment 0, 6, and 8. Conversely, PET/ceCT showed high sensitivities for all segments ranging between 60% and 85%. They concluded that PET/ceCT as single examination is more accurate than PET/CT [1]. …