Peritoneal metastases: Detection with spiral CT in patients with ovarian cancer Journal Article


Authors: Coakley, F. V.; Choi, P. H.; Gougoutas, C. A.; Pothuri, B.; Venkatraman, E.; Chi, D.; Bergman, A.; Hricak, H.
Article Title: Peritoneal metastases: Detection with spiral CT in patients with ovarian cancer
Abstract: PURPOSE: To determine the accuracy of spiral computed tomography (CT) in the depiction of peritoneal metastases by using surgical findings in patients with ovarian cancer as the standard of reference. MATERIALS AND METHODS: Three independent readers reviewed the preoperative CT scans obtained in 64 patients who underwent primary surgery for ovarian cancer. Readers rated the likelihood of peritoneal metastases on a five-point scale and recorded the presence or absence of ascites, parietal peritoneal thickening or enhancement, and small-bowel wall thickening or distortion. Peritoneal metastases were identified as nodular, plaquelike, or infiltrative soft-tissue lesions in the peritoneal fat or on the peritoneal surface. Area under the receiver operating characteristic curve was calculated for each reader. Interreader agreement was evaluated with the K statistic. Descriptive statistical data were determined with dichotomized ratings (1-3 = absent; 4-5 = present). RESULTS: Areas under the receiver operating characteristic curves for the three readers were 0.95, 0.93, and 0.89. Paired kappa values ranged from 0.75 to 0.91. Reader sensitivity for metastases 1 cm or smaller in maximum diameter (25%-50%) was significantly (P < .05) lower than overall sensitivity (850/0-93%). Ascites, parietal peritoneal thickening or enhancement, and small-bowel wall thickening or distortion demonstrated positive predictive values of 72%-93%, with kappa values of 0.12-0.80. CONCLUSION: Spiral CT is accurate in the depiction of peritoneal metastases from ovarian cancer, although sensitivity is reduced in patients with tumor implants 1 cm or smaller. Ancillary signs of peritoneal malignancy are limited by low interobserver agreement. (C) RSNA, 2002.
Keywords: malignancy; carcinomatosis; computed-tomography; mimicking; computed tomography (ct), helical; ovary, neoplasms; peritoneum, ct; peritoneum, neoplasms
Journal Title: Radiology
Volume: 223
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2002-05-01
Start Page: 495
End Page: 499
Language: English
ACCESSION: WOS:000175270000032
DOI: 10.1148/radiol.2232011081
PROVIDER: wos
PUBMED: 11997559
Notes: Article -- Source: Wos
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  1. Venkatraman Ennapadam Seshan
    385 Seshan
  2. Patricia Choi
    4 Choi
  3. Dennis S Chi
    712 Chi
  4. Bhavana Pothuri
    14 Pothuri
  5. Fergus Coakley
    21 Coakley
  6. Hedvig Hricak
    421 Hricak