Aims and objectives
Background
Peritoneal carcinomatosis is considered an enigma for the operating surgeon as many a times intra-operative findings are more sinister than the pre-operative assessment.
Many consider CT-scan as inadequate in quantifying disease burden.
The aim of this study was to assess accuracy of MDCT in evaluating disease burden of peritoneal surface malignancies (PSM) by comparing preoperative radiological (PR) and intra-operative (IO) peritoneal carcinomatosis index
Introduction
Peritoneal carcinomatosis is the most common secondary tumor affecting the peritoneal cavity.
It occurs most commonly with the cancers of...
Methods and materials
43 patients of PSM who underwent CRS between May 2011 to July 2013 at Saifee hospital,
Mumbai were included in this study.
MDCTs of these patients were evaluated using Sugarbaker's chart by two radiologists who were blinded to the IO-PCI and there values were averaged to 1 reading.
PCI in the various abdomino-pelvic region were obtained clockwise (A0 - A12) & total points in each space in CT & IO were calculated.
The total points in each space in CT & IO were calculated.
Both...
Results
Study population included 19 males (44.2%) and 24 females (55.8%) with mean age of 49.7(21 to 75).
There were 17(39.5%) cases of pseudomyxoma peritonei (PMP); 15(34.9%) of GI-tract malignancy (GI) & 11(25.6%) of recurrent Ca ovary/primary peritoneal carcinoma (OVARY).
The mean PCI (PR/IO) were (21.4/25.1) for PMP,
(15.1/20.8) for GI and (13.7/16.9) for OVARY with underestimation of 79.6%,
73.3% & 72.7% respectively in each subgroup of cases.
Average underestimation was seen in 72.1 % cases while average quadrant wise underestimation was noted in approximately 78%...
Conclusion
Calculation of PCI on MDCT using Sugarbaker`s chart demonstrates good accuracy in spite of underestimation in majority of cases and this imaging modality can be effectively used for evaluation of extent of peritoneal carcinomatosis prior to Cytoreductive surgery + HIPEC.
However the most important challenge is to minimise underestimation so that decision making will not be altered when cytoreductive surgery + HIPEC is contemplated.
Even with spatial resolution of MDCT there seems to be difficulty
in accurately assessing lesions < 0.5 cm (LS = 1)....
Personal information
VISHAL KUMAT,
DNB RADIOLOGY RESIDENT
DEPARTMENT OF IMAGING ,
SAIFEE HOSPITAL,
MUMBAI
EMAIL :
[email protected]
RAJEEV MEHTA,
MD,
DMRE
CHAIRMAN OF DEPARTMENT OF IMAGING ,
SAIFEE HOSPITAL,
MUMBAI
EMAIL :
[email protected]
ZUBAIR KAZI,
DNB,
DMRE
DEPARTMENT OF IMAGING ,
SAIFEE HOSPITAL,
MUMBAI
EMAIL :
[email protected]
SANKET MEHTA,
DNB (ONCO-SURG)
DEPARTMENT OF SRGICAL ONCOLOGY ,
SAIFEE HOSPITAL,
MUMBAI
EMAIL :
[email protected]
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