Peritoneal deposits: PET/CT the keen observer

Abstract

Abstract Background The peritoneum is the largest serous membrane in the body, it is a preferred site for metastasis of primary malignancies like mesothelioma. Accurate monitoring of tumor response to chemotherapy and detection of tumor recurrence is critical in management planning. CT is the gold standard for the detection of peritoneal deposits. PET scans are performed on patients with a variety of malignancies. Results The study included 70 patients, 36 females, and 34 males. The age ranged from 5 to 76 years. 59 patients presented to the PET CT unit with known 1ry tumor while 11 patients presented with metastasis of unknown 1ry. Lymphoma followed by colon were the commonest sites for the primary tumor with 15 and 13 patients for each respectively. Breast came in the 3rd place followed by endometrial carcinoma with 12 and 6 patients respectively. Bronchogenic carcinoma came after with 4 patients. Then melanoma, cervical, ovarian, and NET with 2 patients for each. One case had HCC. After performing the PET CT scan we detect the primary neoplastic process for 8 patients out of the 11 previously unknown cases and 3 cases being the unknown origin. These 8 patients were found to be 3 cases with 1ry breast lesions, 2 cases with ovarian masses, and the last 3 cases were colonic, HCC, and lymphoma. 60 of the patients included had peritoneal deposits while 10 were free. Ten patients were reviewed, finding 8 patients were free on CT and PET images, while 2 patients had avid spots. These spots were reviewed turning to be normal bowel activity. Visibility of the peritoneal deposits on CT images was observed, 33 patients had deposits that were not visualized on CT, and 27 were visible. The avid peritoneal deposits were observed. Fifty-eight patients had avid deposits while two patients had non-avid deposits. Fifty-five patients had high-grade avidity deposits while 3 patients had low-grade avidity deposits. Conclusions Evaluation of peritoneal malignancies with PET/CT is rewarding adding substantially to CT scanning alone.