Abstract
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Introduction: The purpose of this exhibit is to illustrate the imaging spectrum of peritoneal carcinomatosis with representative 18F-FDG PET/CT images in abdominopelvic and other malignancies.
Methods: Learning Objectives: Peritoneal carcinomatosis refers to the nodular and/or diffuse spread of metastatic deposits throughout the peritoneal cavity (omental cake), commonly from gastrointestinal or gynecologic malignancies. The metastases gain access to the peritoneum by any of the four principal routes: 1) hematogenous, 2) lymphatic, 3) contiguous spread, and 4) intraperitoneal seeding. The presence of a peritoneal tumor can alter tumor staging, which will have implications to the management and prognosis. 18F-FDG-PET/CT has been shown to improve staging, evaluating therapy response, and early detection of recurrent disease. 18F-FDG PET/CT is also helpful in selection of suitable sites for biopsy. Pseudomyxoma peritonei is associated with tumors of mucinous histology which shows poor FDG uptake. Carcinomas arising elsewhere in the body, including lymphomas and sarcomas, may also produce diffuse peritoneal metastasis. The most salient non-malignant entities to be considered for differential diagnosis are: granulomatous pathologies such as tuberculosis and less often, peritoneal histoplasmosis.
Results:
Conclusions: Summary: 18F-FDG-PET/CT provides valuable metabolic information for the staging and treatment monitoring of peritoneal carcinomatosis. Familiarity with the imaging patterns, and the potential interpretation pitfalls that may influence treatment decisions are to be considered for optimal patient outcomes.
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