• Felipe S Furtado, Mark Z Wu, Shadi A Esfahani, Cristina R Ferrone, Lawrence S Blaszkowsky, Jeffrey W Clark, David P Ryan, Lipika Goyal, Joseph W Franses, Jennifer Y Wo, Theodore S Hong, Motaz Qadan, Kenneth K Tanabe, Colin D Weekes, James C Cusack, Francesco Crafa, Umar Mahmood, Mark A Anderson, Amirkasra Mojtahed, Peter F Hahn, Peter Caravan, Aoife Kilcoyne, Mark Vangel, Robin M Striar, Bruce R Rosen, and Onofrio A Catalano.
• Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
• Ann. Surg. 2023 Apr 1; 277 (4): e893e899e893-e899.

ObjectiveTo compare positron emission tomography (PET)/magnetic resonance imaging (MRI) to the standard of care imaging (SCI) for the diagnosis of peritoneal carcinomatosis (PC) in primary abdominopelvic malignancies.Summary Background DataIdentifying PC impacts prognosis and management of multiple cancer types.MethodsAdult subjects were prospectively and consecutively enrolled from April 2019 to January 2021. Inclusion criteria were: 1) acquisition of whole-body contrast-enhanced (CE) 18F-fluorodeoxyglucose PET/MRI, 2) pathologically confirmed primary abdominopelvic malignancies. Exclusion criteria were: 1) greater than 4 weeks interval between SCI and PET/MRI, 2) unavailable follow-up. SCI consisted of whole-body CE PET/computed tomography (CT) with diagnostic quality CT, and/or CE-CT of the abdomen and pelvis, and/or CE-MRI of the abdomen±pelvis. If available, pathology or surgical findings served as the reference standard, otherwise, imaging followup was used. When SCI and PET/MRI results disagreed, medical records were checked for management changes. Follow-up data were collected until August 2021.ResultsOne hundred sixty-four subjects were included, 85 (52%) were female, and the median age was 60 years (interquartile range 50-69). At a subject level, PET/MRI had higher sensitivity (0.97, 95% CI 0.86-1.00) than SCI (0.54, 95% CI 0.37-0.71), P < 0.001, without a difference in specificity, of 0.95 (95% CI 0.90-0.98) for PET/MRI and 0.98 (95% CI 0.93-1.00) for SCI, P ¼ 0.250. PET/MRI and SCI results disagreed in 19 cases. In 5/19 (26%) of the discordant cases, PET/MRI findings consistent with PC missed on SCI led to management changes.ConclusionPET/MRI improves detection of PC compared with SCI which frequently changes management.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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