18F-FDG-PET/CT of peritoneal tumors: a pictorial essay

Our plain-English summary of 18F-FDG-PET/CT of peritoneal tumors: a pictorial essay, by J. Dubreuil, F. Giammarile, P. Rousset, et al (Nuclear Medicine Communications, 2017).

The study

• Authors: J. Dubreuil, F. Giammarile, P. Rousset, D. Rubello, P.M. Colletti, O. Glehen, A. Skanjeti
• Journal: Nuclear Medicine Communications
• Published: 2017;38(1):1-9
• Type of article: Review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Cancer imaging on the peritoneum is quite difficult on PET/CT because of the particular anatomical features of this membrane. The abdominal cavity can be the seat of very different primary or secondary tumoral lesions, with heterogeneous aggressiveness and variable fluorine-18 fluorodeoxyglucose uptake and patterns. We aimed to depict a spectrum of appearances with abnormal fluorine-18 fluorodeoxyglucose uptakes localized on the peritoneum in frequent conditions such as peritoneal carcinomatosis and in rarer disease such as desmoplastic round cell tumor.

In plain English

This pictorial review showed how tumors of the peritoneum (the abdominal lining) look on 18F-FDG-PET/CT, a scan highlighting tissues that use more glucose. It did not study asbestos exposure. Images came from individual patients aged 26 to 73, in eleven figures. Three related to peritoneal mesothelioma: two malignant forms and one multicystic peritoneal mesothelioma, a rare benign tumor. A 31-year-old woman with sarcomatoid mesothelioma of the peritoneum had focal, intense, uneven uptake. A 63-year-old man with epithelioid mesothelioma had diffuse, intense uptake (SUVmax, a measure of uptake, of 9.9). The authors wrote that, from experience, multicystic peritoneal mesothelioma typically shows diffuse uptake lower than the liver background; their example, a 43-year-old man, had uptake (SUVmax 4.2) just higher than liver background. Other figures included desmoplastic round cell tumor (SUVmax 7.5) and pseudomyxoma peritonei (very low uptake, SUVmax 2.32). The article stated, without a source, that unlike pleural mesothelioma, asbestos exposure has not been proven a risk factor for malignant diffuse peritoneal mesothelioma. The authors wrote that imaging the peritoneum on PET/CT is quite difficult.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Pictorial review (narrative review illustrated with individual patient images); labeled a review article
• Who was studied: Individual patients aged 26 to 73 with various peritoneal tumors, one per figure across 11 figures. The article does not say how cases were selected, where, or when they were imaged.
• Exposure: No exposure was studied. The subject is the imaging test 18F-FDG-PET/CT. Asbestos is mentioned only in one unreferenced statement about malignant diffuse peritoneal mesothelioma.
• Main results:
  • A 31-year-old woman with sarcomatoid mesothelioma of the peritoneum, treated 2 years earlier, showed focal intense heterogeneous FDG uptake on the right lumbar area.
  • A 63-year-old man with abdominal pain and distension showed diffuse, intense uptake of peritoneal membranes and an epiploic cake, with SUVmax of 9.9. Histopathology diagnosed epithelioid mesothelioma.
  • For multicystic peritoneal mesothelioma, the authors wrote from their own experience that FDG uptake is typically diffuse and lower than the liver background, and that on CT the tumor appears as a small cystic tumor with septa. They cited Fig. 3 for this.
  • In the case shown in Fig. 3, a 43-year-old man with abdominal pain and a cystic lesion had relatively low, heterogeneous uptake with SUVmax 4.2, just higher than the liver background.
  • Citing earlier work, the authors described FDG uptake in malignant diffuse peritoneal mesothelioma as typically high, with a diffuse, focal, or mixed pattern.
  • A 26-year-old man with desmoplastic small cell round tumor showed intense uptake on the peripheral areas (SUVmax 7.5), with less uptake in the central necrosis.
  • A 65-year-old man with pseudomyxoma peritonei showed diffuse ascites with very low uptake (SUVmax 2.32), close to the liver background.
• The authors' conclusion: The article has no formal conclusion section. The authors stated that cancer imaging on the peritoneum is difficult on PET/CT because of the membrane's anatomy.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneum, Desmoplastic Mesothelioma.

Related studies

• The role of 18F-FDG-PET/ceCT in peritoneal mesothelioma — J. Dubreuil, F. Giammarile, et al. (2017)
• Focal Peritoneal Mesothelioma Demonstrated on FDG PET/CT — J. Xiao, H. Yin, et al. (2019)
• A Case of Localized Malignant Peritoneal Mesothelioma With Lung Cancer Detected by 18F-FDG PET/CT — S. Kobayashi Shimizu, T. Okamura, et al. (2020)
• 18F-FDG Uptake of Localized Malignant Peritoneal Mesothelioma — E. Kodama, T. Kodama, et al. (2020)
• Whole-Body MRI: Comparison of Its Capability for TNM Staging of Malignant Pleural Mesothelioma With That of Coregistered PET/MRI, Integrated FDG PET/CT, and Conventional Imaging — Y. Ohno, M. Yui, et al. (2019)
• Present and future roles of FDG-PET/CT imaging in the management of malignant pleural mesothelioma — K. Kitajima, H. Doi, et al. (2016)

Browse more research in Nuclear Medicine Communications, or return to medical research.