Andrea Laghi1, Davide Bellini2, Marco Rengo2, Fabio Accarpio3, Damiano Caruso2, Daniele Biacchi3, Angelo Di Giorgio3, Paolo Sammartino3. 1. Department of Radiological Sciences, Oncology and Pathology, "SAPIENZA" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy. andrea.laghi@uniroma1.it. 2. Department of Radiological Sciences, Oncology and Pathology, "SAPIENZA" University of Rome, I.C.O.T. Hospital, Via Franco Faggiana, 1668, 04100, Latina, Italy. 3. Department of Surgery "P. Valdoni", "SAPIENZA" University of Rome, Policlinico Umberto I Hospital, Viale Regina Elena 324, Rome, 00161, Italy.
Abstract
PURPOSE: Primary end point was to assess diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting peritoneal metastases (PM). Secondary end points were determining the diagnostic sensitivity and specificity of CT in detecting PM according to the peritoneal cancer index (PCI), investigating correlations between radiological and surgical PCI, and comparing diagnostic yield of CT versus positron emission tomography (PET)/CT. MATERIALS AND METHODS: We searched MEDLINE, Cochrane Library, Embase and Web of Science databases. Analytic methods were based on PRISMA. Pooled estimates for sensitivity, specificity, positive and negative likelihood ratios were calculated using fixed and random effect models. I 2 was used to evaluate heterogeneity. RESULTS: Of the 529 articles initially identified, 22 were selected for inclusion (934 patients). Cumulative data for per patient CT diagnostic accuracy were sensitivity 83 % (95 % CI 79-86 %), specificity 86 % (95 % CI 82-89 %), pooled positive LR 4.37 (2.58-7.41), and pooled negative LR 0.20 (0.11-0.35). On a per region basis CT performed best in epigastrium and pelvis. Correlation analysis showed a high correlation between CT-PCI and surgical-PCI scores, ranging from 0.49 to 0.96. MRI and PET/CT achieved similar per patient diagnostic accuracy. CONCLUSIONS: CT should be the preferred diagnostic imaging modality for detecting peritoneal metastases because of the robustness of the data. MRI and PET/CT should be considered second choices, until more consistent information on their diagnostic yield in detecting PM are obtained.
PURPOSE: Primary end point was to assess diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting peritoneal metastases (PM). Secondary end points were determining the diagnostic sensitivity and specificity of CT in detecting PM according to the peritoneal cancer index (PCI), investigating correlations between radiological and surgical PCI, and comparing diagnostic yield of CT versus positron emission tomography (PET)/CT. MATERIALS AND METHODS: We searched MEDLINE, Cochrane Library, Embase and Web of Science databases. Analytic methods were based on PRISMA. Pooled estimates for sensitivity, specificity, positive and negative likelihood ratios were calculated using fixed and random effect models. I 2 was used to evaluate heterogeneity. RESULTS: Of the 529 articles initially identified, 22 were selected for inclusion (934 patients). Cumulative data for per patient CT diagnostic accuracy were sensitivity 83 % (95 % CI 79-86 %), specificity 86 % (95 % CI 82-89 %), pooled positive LR 4.37 (2.58-7.41), and pooled negative LR 0.20 (0.11-0.35). On a per region basis CT performed best in epigastrium and pelvis. Correlation analysis showed a high correlation between CT-PCI and surgical-PCI scores, ranging from 0.49 to 0.96. MRI and PET/CT achieved similar per patient diagnostic accuracy. CONCLUSIONS: CT should be the preferred diagnostic imaging modality for detecting peritoneal metastases because of the robustness of the data. MRI and PET/CT should be considered second choices, until more consistent information on their diagnostic yield in detecting PM are obtained.
Entities:
Keywords:
Accuracy; Computed tomography; Magnetic resonance imaging; Peritoneal Cancer Index; Peritoneal carcinomatosis
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