الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 173 |  |  |
| | | from | 173 | | |
Abstract
The diagnosis of peritoneal carcinomatosis is challenging & can be difficult to detect with imaging, especially the detection of small-sized peritoneal lesions. The presence of peritoneal neoplastic spread alters tumor staging and is one of the most significant prognostic indicators in several malignancies, especially in ovarian cancer and colorectal carcinoma in-which the prognostic significance of peritoneal spread is superior and more powerful for adverse outcome than tumor extent or lymph node involvement. Therefore, early detection and localization is of crucial importance for possible surgical treatment or cytoreductive therapy before surgery. The present study was done to highlight the diagnostic value of PET/CT in the detection of peritoneal carcinomatosis in patients with malignant neoplastic disease. In this prospective study patients with primary malignant tumors suspected to have peritoneal carcinomatosis were included. All patients performed PET/CT scans with calculation of the maximum uptake value for every lesion. A maximum of SUV more than 5 was considered significant. Thirty patients with different primary tumours were included in this study. The most frequent primary tumours to disseminate to the peritoneum were colonic mucinous adenocarcinoma (10%), gastric adenocarcinoma poorly differentiated type (10%), ovarian serous cystadenocarcinoma (10%) and metastasis of unknown primary (MUP) (10%). This study reported that the best SUVmax cut-off value was 5 for diagnosis of peritoneal carcinomatosis as assessed by PET/CT. The sensitivity was 76.2% and specificity was 88.9%. Positive predictive value (PPV) was (94.1%), the Negative Predictive Value (NPV) was (61.5%) and accuracy was (80.0%). The range of FDG Uptake among all enrolled patients was (1.3 – 25.0) with a mean SUVmax of FDG Uptake = (8.04 ± 6.14). The SUVmax of FDG Uptake was found > 5 in 17 patients (56.7%), while was found ≤ 5 in 13 patients (43.3%). Moreover, synchronous peritoneal metastases were significantly more frequent than metachronous peritoneal metastases in the present study. The ovarian, colonic and gastric carcinoma as well as metastasis of unknown primary were the most common tumours associated with synchronous peritoneal metastases. Different sites of peritoneal metastases were found in the present study. The most frequent sites of peritoneal metastases included the greater omentum (25.7%) and the bowel serosal surfaces (22.8%). Different morphologies of peritoneal metastases were also noted in the present study. The nodularity was the most frequent morphology of peritoneal metastasis. Regarding the consistency of peritoneal carcinomatosis, solid pattern was the most frequent consistency among all tumors included in the present study especially metastasis from colonic carcinoma. The internal break down was the second frequent consistency of peritoneal metastasis mainly from the ovarian carcinoma. The smallest metastatic nodule detected in this study was 0.5 cm seen in endometrial, colon, gastric, breast and esophageal cancer as well as metastasis of unknown primary patients. On the other hand, the largest metastatic nodule was 11 cm, which was found in lung cancer patient.