Radiology of peritoneal carcinomatosis

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Abstract
Radiologic evaluation of the liver, lungs, and retroperitoneum to detect primary or recurrent cancer has been shown to achieve great accuracy. Computed tomography (CT) will reliably detect lesions of 1 cm diameter in all these locations. Special studies can make the CT even more sensitive with some loss of specificity. Within the abdomen and pelvis, the accuracy of CT examination markedly diminishes. The size threshold for reliable (90%) lesion detection increases to several centimeters in some disease states. The tumor biology of cancer dissemination on abdominopelvic surfaces differs considerably from the dissemination that occurs through lymphatic channels or through the bloodstream. In this chapter we attempt to use the natural history of peritoneal carcinomatosis and Sarcomatosis to assist in the interpretation of radiologic findings. Also, unique radiologic features of mucinous adenocarcinoma, adenocarcinoma, and sarcoma dissemination on abdominal and pelvic surfaces are illustrated. A search for a new level of understanding of abdominal and pelvic CT in patients with peritoneal carcinomatosis or Sarcomatosis is sought.