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Multidetector CT of Peritoneal Carcinomatosis from Ovarian Cancer¹

¹ From the Russell H. Morgan Department of Radiology and Radiological Science (H.K.P., E.K.F.) and Kelly Gynecologic Oncology Service (R.E.B., F.J.M.), Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly. Received May 23, 2002; revision requested July 9 and received September 20; accepted September 23. Address correspondence to H.K.P. (e-mail: hpannu@jhmi.edu).

Ovarian cancer is usually in an advanced stage at diagnosis due to the presence of peritoneal carcinomatosis, which develops as a result of peritoneal fluid circulation. Tumor implants of varying size can occur anywhere from the diaphragm through the pelvis. Computed tomography (CT) can be used to detect these metastatic lesions, which can be miliary or large and appear as soft-tissue or low-attenuation masses. Recent advances in CT technology have increased the flexibility of image acquisition, thereby allowing the use of thin sections and multiplanar reformatting. With multidetector CT, thin-section images of the abdomen and pelvis can be obtained to assess for subcentimeter implants and to create three-dimensional images with reduced artifact. Multiplanar reformatting can be used to confirm the presence of implants. Structures such as the diaphragm, paracolic gutters, bowel, and cul-de-sac can be evaluated in multiple planes for surface nodularity and small implants. Interactive multiplanar review of the abdomen and pelvis has the potential to improve detection of peritoneal metastases at CT.

© RSNA, 2003

Index Terms: Computed tomography (CT), technology, 791.1211, 791.12117 • Ovary, neoplasms, 852.32 • Peritoneum, anatomy, 791.92 • Peritoneum, CT, 791.1211 • Peritoneum, neoplasms, 791.33

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