Diagnostic Performance of Multidetector Computed
Tomography (MDCT) in Evaluation for Peritoneal
Metastasis in Gastric Cancer
Sopa Pongpornsup MD*, Pira Neungton MD*,
Somchai Chairoongruang MD*, Piyaporn apisarnthanarak MD*
Affiliation :
* Department of Diagnostic Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Determine the characteristic imaging findings and accuracy for diagnosis of peritoneal metastasis in gastric
cancer by 64-slice multidetector computed tomography (MDCT).
Material and Method: A retrospective study was performed in 50 patients with gastric cancer who underwent 64-slice
MDCT. The patients were enrolled between January 2006 and March 2011. The MDCT scan of abdomen from patients with
gastric cancer was retrospectively evaluated by two gastrointestinal radiologists without knowledge of each patient’s history,
clinical data, and final diagnosis. Readers recorded the presence or absence of ascites, increased peritoneal fat density,
peritoneal thickening or enhancement, and peritoneal nodule or mass. Sensitivity, specificity, accuracy, positive predictive
value (PPV), and negative predictive value (NPV) of CT scan were calculated.
Results : Twenty-five patients from 50 patients indicated presence of peritoneal metastasis. The accuracies of 64-sliced
MDCT of ascites, increased peritoneal fat density, peritoneal thickening/enhancement, and peritoneal nodule are 80.00,
80.00, 68.00, and 84.00%, respectively.
Conclusion : The 64-slice MDCT is a non-invasive imaging method that can be used for diagnosing staging gastric cancer
with carcinomatosis peritoneii. It is an important tool for further investigation and proper treatment. Peritoneal nodules,
increased peritoneal fat density, ascites, and peritoneal thickening/enhancement are ancillary signs suggestive of peritoneal
carcinomatosis. However, in equivocal cases of imaging study, further investigation with laparoscopy is suggested to rule
out small or miliary peritoneal metastasis.
Keywords : Gastric cancer, Stomach neoplasm, Peritoneal metastasis, Peritoneal carcinomatosis, Peritoneal spreading
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