COMPUTED TOMOGRAPHY OF INTRAPERITONEAL MALIGNANCY

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Abstract
A review of 205 abdominal computed tomographic (CT) scans in 83 patients with gastric or ovarian neoplasms was performed to assess their contribution to management. Assessment of scan accuracy was based on results of invasive procedures, clinical data and double-blind re-reporting. Scans appeared to be of greater value in patients with ovarian rather than gastric neoplasms (P < 0.001), and in patients undergoing clinically-indicated rather than routine scans (P < 0.001). No clinical benefit accrued from the use of pre-treatment scans. Overall accuracy of scanning was judged to be significantly greater for the ovarian than the gastric group (P < 0.001), while concordance of scan reports with re-reporting was also greater in the ovarian group (P < 0.001). The data indicate the inherent limitations of the CT scan and the high degree of subjectivity in its interpetation, particularly when used in the follow-up of patients with known or suspected recurrent gastric cancer. CT scanning remains a potentially useful adjunct to clinical assessment of patients with i.p. malignancy, but should not be regarded as obviating the need for clinical judgement in management decisions.