ABSTRACT
A 39-year-old woman with locally advanced left breast cancer (T4 N0 M0) underwent equilibrium radionuclide ventriculography for baseline assessment of left ventricular function before neoadjuvant chemotherapy. The left ventricular ejection fraction was 76% at 75 beats per minute, without localized wall motion abnormality. In the best septal left anterior oblique projection, a large photopenic "halo" surrounded the cardiac chambers, mimicking a pericardial effusion. In fact, this aspect resulted from an attenuation artifact by a large left breast tumor, as demonstrated by FDG-PET/CT imaging.
Subject(s)
Artifacts , Breast Neoplasms/diagnostic imaging , Diagnostic Errors/prevention & control , Radionuclide Ventriculography/methods , Ventricular Dysfunction, Left/diagnostic imaging , Adult , False Positive Reactions , Female , HumansSubject(s)
Cystadenoma, Mucinous/diagnosis , Iodine Radioisotopes/pharmacokinetics , Ovarian Neoplasms/diagnosis , Struma Ovarii/diagnosis , Adult , Cystadenoma, Mucinous/diagnostic imaging , Diagnosis, Differential , Female , Humans , Ovarian Neoplasms/diagnostic imaging , Radionuclide Imaging , Struma Ovarii/diagnostic imaging , Thyroid Neoplasms/surgery , Thyroidectomy , UltrasonographyABSTRACT
BACKGROUND: Peritoneal carcinomatosis (PC) is associated with a very poor prognosis. Complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy has been shown to improve survival rates of PC. However, this treatment is beneficial for patients if the complete cytoreductive surgery is macroscopically completed before implementing hyperthermic intraperitoneal chemotherapy. Even so, a strict selection of patients is of fundamental importance because of the invasive nature of the intervention. The aim of this study was to assess the performance of FDG-PET/CT examinations for the diagnosis and evaluation of the extent of PC. METHODS: A retrospective analysis was conducted on 28 consecutive patients with suspected PC, scheduled for a complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, and who underwent an FDG-PET/CT examination. We compared the results of PET examinations with histological and intraoperative findings. The extent of PC was assessed precisely using a simplified 'peritoneal cancer index', within the three modalities (PET, surgery and histology). RESULTS: Of 28 patients, 23 had histological PC. The sensitivity and specificity of the PET examination for the diagnosis of PC were, respectively, 82 and 100%. Even if the extent of PC was underestimated by PET, there was a good correlation when compared with histology and intraoperative results. CONCLUSION: PET presented a good performance level in the diagnosis and evaluation of the extent of PC. PET/CT examinations could be useful to avoid unnecessary surgery.