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Erschienen in:

01.10.2012

Peritoneal carcinomatosis: comparison of dynamic contrast-enhanced magnetic resonance imaging with surgical and histopathologic findings

verfasst von: Bernhard Daniel Klumpp, Philip Aschoff, Nina Schwenzer, Michael Fenchel, Ingmar Koenigsrainer, Claudius Falch, Bjoern Bruecher, Claus D. Claussen, Alfred Koenigsrainer, Christina Pfannenberg, Ulrich Kramer, Stephan Miller

Erschienen in: Abdominal Radiology | Ausgabe 5/2012

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Abstract

Objective

In patients with peritoneal carcinomatosis (PC) accurate preoperative assessment is essential to determine indication and surgical procedure to ensure optimal outcome. Purpose of our study was to assess the diagnostic accuracy (DA) of multiphasic dynamic contrast-enhanced MRI to determine the extent of PC in correlation with surgical and histopathological findings.

Materials and methods

14 Patients with proven PC were examined on a 1.5T system before peritonectomy and hyperthermic intraperitoneal chemotherapy. Patient preparation included oral application of 2000 mL mannitol solution and 40 mg butylscopolaminiumbromid i.v. Coronal contrast-enhanced multiphasic dynamic T1w 3D gre sequences (T1W DCE) (0.15 mmol Gd-chelate/kg bw) covering the whole abdomen were acquired (TR 2.9 ms, TE 1.1 ms, resolution 2.0 × 2.0 × 1.8 mm, FOV 400 × 400 mm). MRI was assessed by two radiologists and correlated with surgical exploration (SE) and histopathology for each segment based on the peritoneal cancer index proposed by Sugarbaker et al.

Results

In total, 182 segments were evaluated. PC was found in 118/121 of 182 segments (reader 1/2) by MRI and in 131 segments by SE. In 4/7 segments MRI was false positive. False negative segments 17/17 in MRI did not result in irresectability. The positive predictive value for PC per segment of MRI was 97%/94%, the negative predictive value 73%/72%, the sensitivity 87%/87% and the specificity 92%/86%. The DA was 88%/87%.

Conclusion

T1W DCE is an accurate and clinical valuable tool for the preoperative assessment of peritoneal tumor spread.

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Titel: Peritoneal carcinomatosis: comparison of dynamic contrast-enhanced magnetic resonance imaging with surgical and histopathologic findings
verfasst von: Bernhard Daniel Klumpp
Philip Aschoff
Nina Schwenzer
Michael Fenchel
Ingmar Koenigsrainer
Claudius Falch
Bjoern Bruecher
Claus D. Claussen
Alfred Koenigsrainer
Christina Pfannenberg
Ulrich Kramer
Stephan Miller
Publikationsdatum: 01.10.2012
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 5/2012
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-011-9825-7

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Peritoneal carcinomatosis: comparison of dynamic contrast-enhanced magnetic resonance imaging with surgical and histopathologic findings