State-of-the-Art Imaging of Peritoneal Carcinomatosis

被引:5
|
作者
Pfannenberg, C. [1 ]
Schwenzer, N. F. [1 ]
Bruecher, B. L. [2 ]
机构
[1] Univ Klinikum Tubingen, Abt Diagnost & Interventionelle Radiol, D-72076 Tubingen, Germany
[2] Univ Klinikum Tubingen, Klin Allgemeine Viszeral & Transplantat Chirurg, D-72076 Tubingen, Germany
关键词
peritoneal carcinomatosis; MR imaging; PET-CT; CT; preoperative evaluation; PERIOPERATIVE INTRAPERITONEAL CHEMOTHERAPY; POSITRON-EMISSION-TOMOGRAPHY; DIFFUSION-WEIGHTED MRI; CYTOREDUCTIVE SURGERY; COMPUTED-TOMOGRAPHY; OVARIAN-CANCER; MULTIDETECTOR CT; COLORECTAL-CANCER; F-18-FDG PET; FDG-PET/CT;
D O I
10.1055/s-0031-1281979
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Imaging studies are essential in the evaluation of patients with suspected or known peritoneal malignancy. Despite major advances in imaging technology in the last few years, the early and adequate detection of a peritoneal dissemination remains challenging because of the great variety in size, morphology and location of the peritoneal lesions. New therapeutic approaches in peritoneal-based neoplasms combining cytoreductive surgery and peritonectomy with hyperthermic intraoperative chemotherapy (HIPEC) suggest improved long-term survival, provided that a complete (macroscopic) cytoreduction is achieved. The preoperative radiological assessment of the extent and distribution of peritoneal involvement plays a vital role in the patient selection process. Despite its known limited accuracy in detecting small peritoneal lesions and the involvement of the small bowel/mesentery, contrast-enhanced MDCT remains the standard imaging modality in the assessment of peritoneal carcinomatosis. MRI, especially with diffusion-weighted images, and FDG-PET/CT are promising methods for the evaluation of peritoneal carcinomatosis with superior results in recent studies, but still have a limited role in selected cases because of high costs and limited availability. Generally, to obtain the most precise readings of peritoneal carcinomatosis, an optimized examination protocol and dedicated radiologists with a deep knowledge of peritoneal pathways and variable morphologies of peritoneal disease are required.
引用
收藏
页码:205 / 213
页数:9
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