Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Peritoneal metastasis represents an advanced stage of malignancy and is associated with significant morbidity and poor prognosis. Accurate assessment of the extent of peritoneal disease is essential for treatment planning, particularly in determining eligibility for cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). The Peritoneal Cancer Index (PCI), proposed by Sugarbaker, is the most widely accepted quantitative scoring system for assessing the distribution and tumour burden of peritoneal metastases. Although operative PCI remains the gold standard, contrast-enhanced multi detector computed tomography (MDCT) serves as the primary preoperative imaging modality for estimating radiological PCI (rPCI) because of its widespread availability, rapid acquisition, and excellent spatial resolution. To evaluate the diagnostic accuracy of multidetector computed tomography in estimating the Peritoneal Cancer Index in patients with peritoneal metastases and to determine its correlation with operative PCI. A retrospective observational study was conducted in the Department of Radiodiagnosis, SreeMookambika Institute of Medical Sciences, from January 2024 to December 2024. Sixty patients with peritoneal metastases from various primary malignancies who underwent contrast-enhanced abdominal CT followed by surgery and/or histopathological confirmation were included. CT examinations were performed using a Siemens SOMATOM 128-slice multidetector CT scanner with a standardized contrast-enhanced protocol. Radiological PCI was calculated according to Sugarbaker's 13-region scoring system and compared with operative PCI. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy, correlation coefficient, and Cohen's kappa agreement. Radiological PCI demonstrated a strong positive correlation with operative PCI. CT accurately identified moderate-to-high tumour burden and showed high diagnostic performance in detecting omental cake, diaphragmatic deposits, pelvic disease, and paracolic gutter involvement. Diagnostic accuracy was comparatively lower for lesions involving the small bowel serosa, mesentery, and deposits measuring less than 5 mm. Overall, multidetector CT provided reliable preoperative estimation of tumour burden and significantly contributed to surgical planning. Contrast-enhanced multi detector CT is a valuable non-invasive imaging modality for preoperative estimation of the Peritoneal Cancer Index. Although CT may underestimate small bowel and microscopic peritoneal deposits, it remains an indispensable investigation for assessing disease extent, predicting surgical resectability, and selecting appropriate candidates for cytoreductive surgery and HIPEC.
How to cite this article:
Vinod , Varshini and Bharath . Diagnostic Performance of Multidetector Computed Tomography in Estimating the Peritoneal Cancer Index: A Retrospective Observational Study.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.2.403.412
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.2.403.412