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Evaluation of Preoperative Computed Tomography in Estimating Peritoneal Cancer Index in Peritoneal Carcinomatosis
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JPY
Abstract
Purpose: To evaluate the utility of CT of peritoneal carcinomatosis (PC) by comparing preoperative radiological and intraoperativeperitoneal cancer index (PCI) scores. Material and method: This study collected 76 patients of PC from differentdisease origins. The sensitivity, specificity and accuracy were calculated in each of the abdominopelvic region, and by tumorhistologic type. Result: An overall sensitivity of CT was 69%. The detection rate was highest in appendix and lowest instomach group(84% and 47%, respectively) by the origin of primary disease. There was a lower detection rate(59% vs 79%, p=0.001), and a higher underestimation rate (29% vs 21%, p<0.05) of small bowel lesion compared with overallabdomino-pelvic region. CT predicted an individual regional PCI score accurately in 65%, underestimated in 24%, andoverestimated in 11%. CT detection rate in small tumor (<0.5 cm) was 29%, and increased to 97% with nodules size exceeding5 cm. CT significantly underestimated the clinical PCI value in overall. Conclusion: The sensitivity of CT in detectingPC was influenced by histologic type, tumor location and size. CT underestimated the clinical PCI score in PC patient.
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