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01-05-2009 | Gastrointestinal Oncology

¹⁸F-FDG-PET/CT to Select Patients with Peritoneal Carcinomatosis for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Authors: Christina Pfannenberg, MD, Ingmar Königsrainer, MD, Philip Aschoff, MD, Mehmet Ö. Öksüz, MD, Derek Zieker, MD, Stefan Beckert, MD, Stephan Symons, Kay Nieselt, PhD, Jörg Glatzle, MD, Claus V. Weyhern, MD, Björn L. Brücher, MD, Claus D. Claussen, MD, Alfred Königsrainer, MD

Published in: Annals of Surgical Oncology | Issue 5/2009

Abstract

Background

Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with significantly longer survival in patients with peritoneal carcinomatosis (PC). So far, no morphological imaging method has proven to accurately assess the intra-abdominal tumor spread. This study was designed to predict tumor load in patients with PC using dual-modality ¹⁸FDG-PET/CT and to compare the results with those of PET and CT alone by correlating imaging findings with intraoperative staging.

Methods

Twenty-two patients with PC from gastrointestinal (n = 13), ovarian cancer (n = 8), and mesothelioma (n = 1) underwent contrast-enhanced ¹⁸FDG-PET/CT before surgery and HIPEC. In a retrospective analysis PET, CT, and fused PET/CT were separately and blindly reviewed for the extent of peritoneal involvement using the Peritoneal Cancer Index (PCI). Imaging results were correlated with the intraoperative PCI using Pearson’s correlation coefficient and linear regression analysis.

Results

There was a strong correlation between the PCI obtained with PET/CT and the surgical PCI with respect to the total score (r = 0.951) as well as in the regional analysis (small bowel, r = 0.838; other, r = 0.703). The correlation was slightly lower for CT alone (total score, r = 0.919; small bowel, r = 0.754; other, r = 0.666) and significantly lower (p = 0.002) for PET alone (total score, r = 0.793; small bowel, r = 0.553, other, 0.507).

Conclusions

Contrast-enhanced CT is superior compared with PET alone to predict the extent of PC. In our patient group, the combination of both modalities (contrast enhanced PET/CT) yielded the best results and proved to be a useful tool for selecting candidates for peritonectomy and HIPEC.

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Title: 18F-FDG-PET/CT to Select Patients with Peritoneal Carcinomatosis for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: Christina Pfannenberg, MD
Ingmar Königsrainer, MD
Philip Aschoff, MD
Mehmet Ö. Öksüz, MD
Derek Zieker, MD
Stefan Beckert, MD
Stephan Symons
Kay Nieselt, PhD
Jörg Glatzle, MD
Claus V. Weyhern, MD
Björn L. Brücher, MD
Claus D. Claussen, MD
Alfred Königsrainer, MD
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-009-0387-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

¹⁸F-FDG-PET/CT to Select Patients with Peritoneal Carcinomatosis for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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