A Dohan1,2, C Hoeffel3, P Soyer1, A S Jannot4, P-J Valette5, A Thivolet5, G Passot6, O Glehen6, P Rousset5. 1. Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Diderot-Paris 7 and Institut National de la Santé et de la Recherche Médicale (INSERM) U965, AP-HP, Paris, France. 2. Department of Radiology, McGill University Health Centre, Montreal, Quebec, Canada. 3. Department of Radiology, Hôpital Robert-Debré, Reims, France. 4. INSERM-Unité Mixte de Recherche en Santé 1138 Team 22, Cordeliers Research Centre, Paris Descartes University, Department of Medical Informatics and Public Health, European George Pompidou Hospital, AP-HP, Paris, France. 5. Department of Radiology, Centre Hospitalier Lyon Sud - Hospices Civils de Lyon, Lyon 1 University, Equipe Mixte de Recherche 3738, Lyon, France. 6. Department of Digestive and Oncological Surgery, Centre Hospitalier Lyon Sud - Hospices Civils de Lyon, Lyon 1 University, Equipe Mixte de Recherche 3738, Lyon, France.
Abstract
BACKGROUND: The aim was to determine the incremental value of MRI compared with CT in the preoperative estimation of the peritoneal carcinomatosis index (PCI). METHODS: CT and MRI examinations of patients with peritoneal carcinomatosis were evaluated. CT images were first analysed by two observers who determined a first PCI (PCICT ). Then, the two observers reviewed MRI examinations in combination with CT and determined a second PCI (PCICT+MRI ). The sensitivity and negative predictive value of the two imaging sets were determined using surgery as a reference standard (PCIRef ). RESULTS: CT plus MRI was more accurate in predicting the surgical PCI than CT alone. The absolute difference between PCICT+MRI and PCIRef was lower than that between PCICT and PCIRef (mean(s.d.) 3·96(4·10) versus 4·89(4·73); P = 0·010). The number of true-positive findings increased from 106 to 125 for reader 1 and from 117 to 132 for reader 2 with the adjunct of MRI. For both readers, an increased sensitivity was obtained when both MRI and CT were used (from 63 to 81 per cent for reader 1; from 44 to 81 per cent for reader 2). The increase in sensitivity was greater for patients with a moderate volume of disease. CONCLUSION: The combination of CT and MRI improved the preoperative estimation of PCI compared with CT alone.
BACKGROUND: The aim was to determine the incremental value of MRI compared with CT in the preoperative estimation of the peritoneal carcinomatosis index (PCI). METHODS: CT and MRI examinations of patients with peritoneal carcinomatosis were evaluated. CT images were first analysed by two observers who determined a first PCI (PCICT ). Then, the two observers reviewed MRI examinations in combination with CT and determined a second PCI (PCICT+MRI ). The sensitivity and negative predictive value of the two imaging sets were determined using surgery as a reference standard (PCIRef ). RESULTS: CT plus MRI was more accurate in predicting the surgical PCI than CT alone. The absolute difference between PCICT+MRI and PCIRef was lower than that between PCICT and PCIRef (mean(s.d.) 3·96(4·10) versus 4·89(4·73); P = 0·010). The number of true-positive findings increased from 106 to 125 for reader 1 and from 117 to 132 for reader 2 with the adjunct of MRI. For both readers, an increased sensitivity was obtained when both MRI and CT were used (from 63 to 81 per cent for reader 1; from 44 to 81 per cent for reader 2). The increase in sensitivity was greater for patients with a moderate volume of disease. CONCLUSION: The combination of CT and MRI improved the preoperative estimation of PCI compared with CT alone.
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