Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists

Our plain-English summary of Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists, by R.A. Vicens, M. Patnana, O. Le, et al (Abdominal Imaging, 2015).

The study

• Authors: R.A. Vicens, M. Patnana, O. Le, P.R. Bhosale, T.L. Sagebiel, C.O. Menias, A. Balachandran
• Journal: Abdominal Imaging
• Published: 2015;40(2):436-56
• Type of article: Review
• Cited by: 32 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Peritoneal disease can be caused by a wide spectrum of pathologies. While peritoneal disease is usually caused by primary or secondary malignancies, benign diseases can occur and mimic malignancies. This article begins with an overview of peritoneal embryology and anatomy followed by a detailed description of the multimodality imaging appearance of peritoneal diseases. Common diseases include peritoneal carcinomatosis, pseudomyxoma peritonei, lymphomatosis, sarcomatosis, and tuberculous peritonitis. The uncommon diseases which cause peritoneal disease include desmoid fibromatosis, desmoplastic small round cell tumor, malignant mesothelioma, well-differentiated mesothelioma, multicystic mesothelioma, papillary serous carcinoma, leiomyomatosis, extramedullary hematopoiesis, inflammatory pseudotumor and amyloidosis. This manuscript will help the radiologist become familiar with the different peritoneal spaces, pathways of spread, multimodality imaging appearance and differential diagnoses of peritoneal diseases in order to report the essential information for surgeons and oncologists to plan treatment.

In plain English

This article was a review written for radiologists, not a new study of patients. The authors described the anatomy of the peritoneum, the lining of the abdominal cavity. They then summarized, from published literature, how a range of common and uncommon peritoneal diseases look on ultrasound, CT, MRI and PET/CT, illustrated with images from individual patients. Malignant peritoneal mesothelioma was one of the uncommon diseases covered. Citing earlier work, the review stated that it makes up 6%–10% of all mesotheliomas. Its listed risk factors include asbestos exposure, therapeutic irradiation and chronic peritoneal irritation, and asbestos-induced peritoneal mesothelioma is more common in men. No asbestos fiber types were named. The review stated that imaging features do not predict the tumor's cell type and that calcifications and lymph node enlargement are usually absent. It also stated that whether PET/CT findings from pleural mesothelioma apply to peritoneal mesothelioma has yet to be studied. It stated that well-differentiated peritoneal mesothelioma has no association with asbestos exposure. The authors concluded that radiologists play a crucial role in diagnosing and staging these diseases.

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: Narrative review for radiologists of peritoneal anatomy and the imaging appearance of peritoneal diseases, illustrated with images from individual patients
• Who was studied: No study population. The review covered published literature on common peritoneal diseases (peritoneal carcinomatosis, pseudomyxoma peritonei, lymphomatosis, sarcomatosis, tuberculous peritonitis) and uncommon ones, including malignant, well-differentiated and multicystic peritoneal mesothelioma. Figures show individual patients, such as a 63-year-old with biopsy-proven malignant peritoneal mesothelioma.
• Exposure: Asbestos was not studied. The review listed asbestos exposure, citing another source, as one risk factor for malignant peritoneal mesothelioma, along with therapeutic irradiation and chronic peritoneal irritation. No fiber types were named.
• Main results:
  • Citing an earlier source, the review stated that malignant mesothelioma is the most common of three types of peritoneal mesothelioma and makes up 6%–10% of all mesotheliomas in the body.
  • The review stated that asbestos-induced peritoneal mesothelioma is more common in men.
  • The review stated that, for malignant peritoneal mesothelioma, the localized pattern has a better prognosis than the diffuse type.
  • The review stated that imaging features of malignant peritoneal mesothelioma do not predict cell type.
  • The review stated that calcifications and lymph node enlargement are usually absent in malignant peritoneal mesothelioma.
  • The review stated that the PET/CT appearance of malignant peritoneal mesothelioma has been described only in case reports. It added that applying PET/CT accuracy figures from pleural mesothelioma to peritoneal mesothelioma has yet to be studied.
  • The review stated that well-differentiated peritoneal mesothelioma, a rare subtype, has no association with asbestos exposure.
• The authors' conclusion: The authors concluded that, although the imaging features of many peritoneal diseases overlap, the radiologist plays a crucial role in diagnosis and staging, and that a multimodality approach can improve diagnostic yield.

Topics

Medical terms in this study, explained in our Lexicon: Desmoplastic Small Round Cell Tumor, Malignant Mesothelioma, Well-Differentiated, Mesothelioma, Multicystic Mesothelioma (MCM), Carcinoma.

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