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Diagnostic value of contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)

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Abstract

Purpose

Aim of the study is 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).

Methods

We retrospectively analyzed data collected from 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. In the case of discordance, the consensus was reached by a discussion between the specialists. Moreover, the combined images were evaluated by all the specialists in consensus. The PCIs obtained from surgical look, PET/CT, ceCT, and PET/ceCT were compared with each other. The coefficients of correlation (r) were calculated. The study was conducted after approval of local ethics committee.

Results

Surgical PCI was available in 21 patients. 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). The r coefficient between surgical PCI and PET/CT was higher in patients with a non-mucinous cancer (n = 12) than the counterpart (0.601 vs. 0.303) and the addition of ceCT significantly increases the correlation (r = 0.863), which is anyway similar to ceCT alone (r = 0.856).

Conclusions

PET/ceCT as single examination is more accurate than PET/CT but not than ceCT alone for the definition of PCI in a selected group of patients candidates to CS + HIPEC.

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Authors and Affiliations

  1. Surgical Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, Via Gattamelata 64, 35122, Padua, Italy

    Antonio Sommariva & Carlo Riccardo Rossi

  2. Nuclear Medicine and Molecular Imaging Unit, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy

    Laura Evangelista & Anna Rita Cervino

  3. Radiology Oncology Unit, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy

    Giovanna Pintacuda & Gaetano Ramondo

Authors
  1. Antonio Sommariva
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  2. Laura Evangelista
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  3. Giovanna Pintacuda
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  4. Anna Rita Cervino
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  5. Gaetano Ramondo
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  6. Carlo Riccardo Rossi
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Corresponding author

Correspondence to Antonio Sommariva.

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Conflict of interest

All the authors declare no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study. The study was conducted in accordance with the Declaration of Helsinki, and was performed after the evaluation and approval of local Ethics committee the 18th January 2016 (IOV-CAR-1-2015 Study).

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Sommariva, A., Evangelista, L., Pintacuda, G. et al. Diagnostic value of contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Abdom Radiol 43, 1094–1100 (2018). https://doi.org/10.1007/s00261-017-1276-3

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  • DOI: https://doi.org/10.1007/s00261-017-1276-3

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