الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Peritoneal carcinomatosis is one of the frequent sites of metastasis in many gastrointestinal and gynecological tumors mostly colorectal and ovarian cancer. It affects the staging, treatment, prognosis and outcome of the patients Thus early analysis of peritoneal spread in malignancy is fundamental to avoid unnecessary laparotomies and to choose the patients in whom complete cyto-reduction is possible.
The aim of this work was to assess the added value of PET/CT imaging in patients with peritoneal carcinomatosis. PET/CT imaging was performed by scanning thorax, abdomen and pelvis.
The present study was conducted on 20 patients with peritoneal carcinomatosis of age ranging between 22 to 80 years old and mean age of 57.15 ± 14.08 years old. 5 patients were males and 15 patients were females. 14 patients were referred for PET/CT imaging for post-therapy evaluation initial assessment while 4 patients were referred to monitor treatment response, one patient was referred for pre-therapy scanning and one patient was referred to scan for primary tumor in metastasis of unknown origin.
Malignant peritoneal involvement can manifest as various imaging patterns on FDG PET/CT imaging. Distinct patterns of glucose metabolism of peritoneal carcinomatosis have been identified that appear as either nodular, mass, plaques or diffuse peritoneal involvement. Awareness of these patterns is crucial for accurate interpretation and to optimize diagnostic accuracy when cancer patients are staged with 18F-FDG PET/CT imaging.
CT scan plays an important role in the detection of peritoneal carcinomatosis and its mimics however, the exact diagnosis and characterization of lesions may be difficult due to the overlap of imaging findings which was easily overcame by using PET/CT imaging
PET/CT imaging shows better characterization of the peritoneal lesions which increases the diagnostic accuracy as well as the reading confidence. It also determines the nature and increase degree of certainty in lesions that seem equivocal on CT.
CT imaging has limitations in detection of peritoneal carcinomatosis noted along the along hepatic surface and serosal lesions while PET/CT showed better sensitivity in detecting those lesions where PET/CT revealed occult lesions that are not visualized by CT alone.
PET/CT imaging showed better post-therapy evaluation than CT alone. It was also able to monitor treatment response by comparing the SUV max measurements before and after treatment which was difficult to assess using CT only especially if lesions showed no significant change in size nor shape.
PET/CT imaging also has the ability to detect primary tumor in patients with metastasis of unknown origin which could not be assessed by CT imaging alone.
PET/CT is recommended for oncology patient for post-therapy evaluation; monitoring treatment response after chemo or radiotherapy.
PET/CT is also recommended in cases of metastasis with unknown origin and also in case of equivocal lesions for better characterization of its nature.