FDG-PET/ceCT is useful to predict recurrence of Pseudomyxoma peritonei

Eur J Nucl Med Mol Imaging. 2016 Aug;43(9):1630-7. doi: 10.1007/s00259-016-3347-z. Epub 2016 Feb 24.


Purpose: Pseudomyxoma peritonei (PMP) is a rare peritoneal neoplasm originating from appendicular tumours. There is no consolidated data available in the literature about the precise role of [(18)F] fluorodesoxy-D-glucose Positron Emission Tomography / contrast enhanced Computed Tomography (FDG-PET/ceCT). The aim of this study was to evaluate the correlation between preoperative FDG-PET/ceCT (qualitative and semi-quantitative assessment) and progression free survival (PFS) of patients treated for PMP.

Methods: All patients scheduled for PMP treatment by cytoreductive unicentric surgery, intraperitoneal chemotherapy (HIPEC), and who underwent a FDG-PET/ceCT between February 2008 and January 2014, were included. No previous treatment was performed (except biopsy or appendectomy). FDG-PET/ceCT was interpreted by two nuclear physicians in consensus. Positive FDG-PET/ceCT scans were further labelled in diffuse disease and poly/mono focal disease. SUVmax was measured based on post-operative reports. The Peritoneal Cancer Index (PCI) and Completeness of CytoReduction Score (CCR) were assessed after surgery.

Results: Fifty-six patients were included in this study, with a mean age of 56-years-old and a mean follow-up of 29.3 months. SUVmax, with a cut-off at 2.02, was predictive for the PFS on multivariate analysis. No differences were observed between diffuse disease and focal disease on PFS for progression free survival, PCI, and SUVmax (p = 0.1). Post-operative CCR was not significantly correlated with SUVmax or FDG-PET/ceCT qualitative assessment.

Conclusion: SUVmax on preoperative FDG-PET/ceCT was an independent predictive factor for PFS in PMP. Further studies are needed to explore if FDG-PET/ceCT could potentially predict post-operative CCR.

Keywords: FDG-PET/ceCT; Intraperitoneal chemotherapy; Prognosis; Pseudomyxoma peritonei; Recurrence.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Male
  • Middle Aged
  • Peritoneal Neoplasms / diagnostic imaging*
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery
  • Positron Emission Tomography Computed Tomography*
  • Preoperative Period
  • Pseudomyxoma Peritonei / diagnostic imaging*
  • Pseudomyxoma Peritonei / pathology
  • Pseudomyxoma Peritonei / surgery
  • Recurrence


  • Fluorodeoxyglucose F18