Multidetector computed tomography (MDCT) of the abdomen is currently the imaging examination of choice for the staging and follow-up of ovarian carcinoma (OC). Peritoneal metastases (PMs) represent the most common pathway for the metastatic spread of OC. MDCT scanners, due to several advantages—including increased volume coverage, reduced scanning time, acquisition of thin slices and creation of multiplanar reformations, and three-dimensional reconstructions—provide useful information regarding the early and accurate detection of PMs. Detailed mapping of peritoneal carcinomatosis is feasible, with improved detection of sub-centimeter peritoneal implants and thorough evaluation of curved peritoneal surfaces.
ForstnerR.Radiological staging of ovarian cancer: imaging findings and contribution of CT and MRI. Eur Radiol2007;
17:3223–3235.
2.
ForstnerRMeissnitzerMCunhaTM.Update on Imaging of Ovarian Cancer. Curr Radiol Rep2016;
4:31.
3.
ForstnerRSalaEKinkelK, et al.
ESUR guidelines: ovarian cancer staging and follow-up. Eur Radiol2010;
20:2773–2780.
4.
KangSKReinholdCAtriM, et al.
ACR Appropriateness Criteria(®) Staging and Follow-Up of Ovarian Cancer. J Am Coll Radiol2018;
15:S198–S207.
5.
Lopez-LopezVCascales-CamposPAGilJ, et al.
Use of (18)F-FDG PET/CT in the preoperative evaluation of patients diagnosed with peritoneal carcinomatosis of ovarian origin, candidates to cytoreduction and hipec. A pending issue. Eur J Radiol2016;
85:1824–1828.
6.
NougaretSAddleyHCColomboPE, et al.
Ovarian carcinomatosis: how the radiologist can help plan the surgical approach. Radiographics2012;
32:1775–1800.
7.
DauwenHVan CalsterBDerooseCM, et al.
PET/CT in the staging of patients with a pelvic mass suspicious for ovarian cancer. Gynecol Oncol2013;
131:694–700.
8.
MutchDGPratJ.2014 FIGO staging for ovarian, fallopian tube and peritoneal cancer. Gynecol Oncol2014;
133:401–404.
9.
PrzybycinCGKurmanRJRonnettBM, et al.
Are all pelvic (nonuterine) serous carcinomas of tubal origin?Am J Surg Pathol2010;
34:1407–1416.
10.
BagulKVijaykumarDKRajanbabuA, et al.
Advanced primary epithelial ovarian and peritoneal carcinoma-does diagnostic accuracy of preoperative CT scan for detection of peritoneal metastatic sites reflect into prediction of suboptimal debulking? A prospective study. Indian J Surg Oncol2017;
8:98–104.
11.
Abdalla AhmedSAbou-TalebHAliN, et al.
Accuracy of radiologic- laparoscopic peritoneal carcinomatosis categorization in the prediction of surgical outcome. Br J Radiol2019;
92:20190163.
12.
RozeJFHoogendamJPvan de WeteringFT, et al.
Positron emission tomography (PET) and magnetic resonance imaging (MRI) for assessing tumour resectability in advanced epithelial ovarian/fallopian tube/primary peritoneal cancer. Cochrane Database Syst Rev2018;
10:CD012567.
13.
AnHLeeEYPChiuK, et al.
The emerging roles of functional imaging in ovarian cancer with peritoneal carcinomatosis. Clin Radiol2018;
73:597–609.
14.
BristowREDuskaLRLambrouNC, et al.
A model for predicting surgical outcome in patients with advanced ovarian carcinoma using computed tomography. Cancer2000;
89:1532–1540.
15.
DowdySCMullanySABrandtKR, et al.
The utility of computed tomography scans in predicting suboptimal cytoreductive surgery in women with advanced ovarian carcinoma. Cancer2004;
101:346–352.
16.
QayyumACoakleyFVWestphalenAC.Role of CT and MR imaging in predicting optimal cytoreduction of newly diagnosed primary epithelial ovarian cancer. Gynecol Oncol2005;
96:301–306.
17.
SuidanRSRamirezPTSarasohnDM.A multicenter prospective trial evaluating the ability of preoperative computed tomography scan and serum CA-125 to predict suboptimal cytoreduction at primary debulking surgery for advanced ovarian, fallopian tube, and peritoneal cancer. Gynecol Oncol2014;
134:455–461.
18.
TempanyCMZouKHSilvermanSG, et al.
Staging of advanced ovarian cancer: comparison of imaging modalities-report from the Radiological Diagnostic Oncology Group. Radiology2000;
215:761–767.
19.
JacquetPSugarbakerPH.Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. In: SugarbakerPH, ed. Peritoneal carcinomatosis: principles of management.
Boston, MA:
Kluwer Academic Publishers, 1996:359–374.
20.
KalovidourisAGouliamosAPontifexG, et al.
Computed tomography of ovarian carcinoma. Acta Radiol Diagn (Stockh)1984;
25:203–208.
21.
SahdevAHughesJHBarwickT, et al.
Computed tomography features of recurrent ovarian carcinoma according to time to relapse. Acta Radiol2007;
48:1038–1044.
22.
WangPHHuangYTNgKK, et al.
Detecting recurrent ovarian cancer: revisit the values of whole-body CT and serum CA 125 levels. Acta Radiol2019;
60:1360–1366.
23.
ZytoonAAMurakamiKEidH, et al.
High Impact of FDG-PET/CT in diagnostic strategies for ovarian cancer. Acta Radiol2013;
54:340–348.
24.
WeiMBoFCaoH, et al.
Diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging for malignant ovarian tumors: a systematic review and meta-analysis. Acta Radiol2020;
2:284185120944916.
25.
RodolfinoEDevicientiEMiccòM, et al.
Diagnostic accuracy of MDCT in the evaluation of patients with peritoneal carcinomatosis from ovarian cancer: is delayed enhanced phase really effective?Eur Rev Med Pharmacol Sci2016;
20:4426–4434.
26.
Grabowska-DerlatkaLDerlatkaPSzeszkowskiW, et al.
Diffusion-weighted imaging of small peritoneal implants in “potentially” early-stage ovarian cancer. Biomed Res Int2016;
2016:9254742.
27.
SchmidtSMeuliRAAchtariC, et al.
Peritoneal carcinomatosis in primary ovarian cancer staging: comparison between MDCT, MRI, and 18F-FDG PET/CT. Clin Nucl Med2015;
40:371–377.
28.
AhmedSAAbou-TalebHYehiaA, et al.
The accuracy of multi-detector computed tomography and laparoscopy in the prediction of peritoneal carcinomatosis index score in primary ovarian cancer. Acad Radiol2019;
26:1650–1658.
29.
TawakolAAbdelhafezYGOsamaA, et al.
Diagnostic performance of 18F-FDG PET/contrast-enhanced CT versus contrast-enhanced CT alone for post-treatment detection of ovarian malignancy. Nucl Med Commun2016;
37:453–460.
30.
IafrateFCiolinaMSammartinoP, et al.
Peritoneal carcinomatosis: imaging with 64-MDCT and 3T MRI with diffusion-weighted imaging. Abdom Imaging2013;
37:616–627.
31.
PatelCMSahdevAReznekRH.CT, MRI and PET imaging in peritoneal malignancy. Cancer Imaging2011;
11:123–139.
32.
CoakleyFVChoiPHGougoutasCA, et al.
Peritoneal metastases: detection with spiral CT in patients with ovarian cancer. Radiology2002;
223:495–499.
33.
PannuHKHortonKMFishmanEK.Thin section dual-phase multidetector-row computed tomography detection of peritoneal metastases in gynecologic cancers. J Comput Assist Tomogr2003;
27:333–340.
34.
PannuHKBristowREMontzFJ, et al.
Multidetector CT of peritoneal carcinomatosis from ovarian cancer. Radiographics2003;
23:687–701.
35.
LaghiABelliniDRengoM, et al.
Diagnostic performance of computed tomography and magnetic resonance imaging for detecting peritoneal metastases: systematic review and meta-analysis. Radiol Med2017;
122:1–15.
36.
van’t SantIEngbersenMPBhairosingPA, et al.
Diagnostic performance of imaging for the detection of peritoneal metastases: a meta-analysis. Eur Radiol2020;
30:3101–3112.
37.
El-AgwanyAS.Laparoscopy and computed tomography imaging in advanced ovarian tumors: a roadmap for prediction of optimal cytoreductive surgery. Gynecol Minim Invasive Ther2018;
7:66–69.
38.
FerrandinaGSallustioGFagottiA, et al.
Role of CT scan based and clinical evaluation in the preoperative prediction of optimal cytoreduction in advanced ovarian cancer: a prospective trial. Br J Cancer2009;
101:1066–1073.
39.
AlcázarJLCaparrosMArraizaM, et al.
Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography. Int J Gynecol Cancer2019. DOI: 10.1136/ijgc-2018-000066.
40.
NasserSLazaridisAEvangelouM, et al.
Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced and relapsed epithelial ovarian cancer: A retrospective evaluation. Gynecol Oncol2016;
143:264–269.
41.
ChandrashekharaSHThulkarSSrivastavaDN, et al.
Pre-operative evaluation of peritoneal deposits using multidetector computed tomography in ovarian cancer. Br J Radiol2011;
84:38–43.
42.
RajanJKuriakoseSRajendranVR, et al.
Radiological and surgical correlation of disease burden in advanced ovarian cancer using peritoneal carcinomatosis index. Indian J Gynecol Oncolog2018;
16:7.
43.
MeleisMHEl-AgwanyAMS.Peritoneal carcinomatosis index in advanced ovarian malignancy either by multislice CT verus laparotomy: a comparative study. Indian J Gynecol Oncolog2015;
13:24.
44.
MazzeiMAKhaderLCiriglianoA, et al.
Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Abdom Imaging2013;
38:1422–1430.
45.
MetserUJonesCJacksLM, et al.
Identification and quantification of peritoneal metastases in patients with ovarian cancer with multidetector computed tomography: correlation with surgery and surgical outcome. Int J Gynecol Cancer2011;
21:1391–1398.
46.
ChoiHJLimMCBaeJ, et al.
Region-based diagnostic performance of multidetector CT for detecting peritoneal seeding in ovarian cancer patients. Arch Gynecol Obstet2011;
283:353–360.
47.
JungDCKangSKimMJ, et al.
Multidetector CT predictors of incomplete resection in primary cytoreduction of patients with advanced ovarian cancer. Eur Radiol2010;
20:100–107.
48.
GadelhakBTawfikAMSalehGA, et al.
Extended abdominopelvic MRI versus CT at the time of adnexal mass characterization for assessing radiologic peritoneal cancer index (PCI) prior to cytoreductive surgery. Abdom Radiol (NY) 2019;
44:2254–2261.
49.
ForstnerRHricakHWhiteS. CT and
MRI of ovarian cancer. Abdom Imaging1995;
20:2–8.
50.
Tsili AC, Tsampoulas C, Charisiadi A, et al. Adnexal masses: accuracy of detection and differentiation with multidetector computed tomography. Gynecol Oncol 2008;110:22–31.
51.
KyriaziSKayeSBdeSouzaNM.Imaging ovarian cancer and peritoneal metastases-current and emerging techniques. Nat Rev Clin Oncol2010;
7:381e93.
52.
GuoHLHeLZhuYC, et al.
Comparison between multi-slice spiral CT and magnetic resonance imaging in the diagnosis of peritoneal metastasis in primary ovarian carcinoma. Onco Targets Ther2018;
11:1087–1094.
53.
MichielsenKDresenRVanslembrouckR, et al.
Diagnostic value of whole body diffusion-weighted MRI compared to computed tomography for pre-operative assessment of patients suspected for ovarian cancer. Eur J Cancer2017;
83:88–98.
54.
FehnigerJThomasSLengyelELiaoC, et al.
A prospective study evaluating diffusion weighted magnetic resonance imaging (DW-MRI) in the detection of peritoneal carcinomatosis in suspected gynecologic malignancies. Gynecol Oncol2016;
142:169–175.
55.
MichielsenKVergoteIOp de BeeckK, et al.
Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT. Eur Radiol2014;
24:889–901.
56.
HynninenJKemppainenJLavoniusM, et al.
A prospective comparison of integrated FDG-PET/contrast-enhanced CT and contrast-enhanced CT for pretreatment imaging of advanced epithelial ovarian cancer. Gynecol Oncol2013;
131:389–394.
57.
KimHWWonKSZeonSK, et al.
Peritoneal carcinomatosis in patients with ovarian cancer: enhanced CT versus 18F-FDG PET/CT. Clin Nucl Med2013;
38:93–97.
58.
FranielTDiederichsGEngelkenF, et al.
Multi-detector CT in peritoneal carcinomatosis: diagnostic role of thin slices and multiplanar reconstructions. Abdom Imaging2009;
34:49–54.
59.
MarinDCatalanoCBaskiM, et al.
64-Section multi-detector row CT in the preoperative diagnosis of peritoneal carcinomatosis: correlation with histopathological findings. Abdom Imaging2010;
35:694–670.
60.
BaeHJungDCLeeJY, et al.
Patterns of initially overlooked recurrence of peritoneal lesions in patients with advanced ovarian cancer on postoperative multi-detector row CT. Acta Radiol2019;
60:1713–1720.
61.
CoakleyFVHricakH.Imaging of peritoneal and mesenteric disease: key concepts for the clinical radiologist. Clin Radiol1999;
54:563–574.
62.
RubiniGAltiniCNotaristefanoA, et al.
Role of 18F-FDG PET/CT in diagnosing peritoneal carcinomatosis in the restaging of patient with ovarian cancer as compared to contrast enhanced CT and tumor marker Ca-125. Rev Esp Med Nucl Imagen Mol2014;
33:22–27.
63.
FunicelliLTravainiLLLandoniF, et al.
Peritoneal carcinomatosis from ovarian cancer: the role of CT and [18F] FDG-PET/CT. Abdom Imaging2010;
35:701–707.
64.
WalkeyMMFriedmanACSohotraP, et al.
CT manifestations of peritoneal carcinomatosis. AJR Am J Roentgenol1988;
150:1035–1041.
65.
TempanyCMZouKHSilvermanSG, et al.
Staging of advanced ovarian cancer: comparison of imaging modalities-report from the Radiological Diagnostic Oncology Group. Radiology2000;
215:761–767.
66.
AkinOSalaEMoskowitzCS, et al.
Perihepatic metastases from ovarian cancer: sensitivity and specificity of CT for the detection of metastases with and those without liver parenchymal invasion. Radiology2008;
248:511–517.
67.
VergoteIBVan NieuwenhuysenEVandersticheleA.How to select neoadjuvant chemotherapy or primary debulking surgery in patients with stage IIIC or IV Ovarian Carcinoma. J Clin Oncol2016;
34:3827–3828.
68.
RisumSHøgdallCLoftA, et al.
Prediction of suboptimal primary cytoreduction in primary ovarian cancer with combined positron emission tomography/computed tomography-a prospective study. Gynecol Oncol2008;
108:265–270.
69.
DohanAHoeffelCSoyerP, et al.
Evaluation of the peritoneal carcinomatosis index with CT and MRI. Br J Surg2017;
104:1244–1249.
70.
LowRNBaroneRMLuceroJ.Comparison of MRI and CT for predicting the Peritoneal Cancer Index (PCI) preoperatively in patients being considered for cytoreductive surgical procedures. Ann Surg Oncol2015;
22:1708–1715.
71.
LowRNBaroneRM.Imaging for Peritoneal Metastases. Surg Oncol Clin N Am2018;
27:425–442.
72.
CastellucciPPerroneAMPicchioM, et al.
Diagnostic accuracy of 18F-FDG PET/CT in characterizing ovarian lesions and staging ovarian cancer: correlation with transvaginal ultrasonography, computed tomography, and histology. Nucl Med Comm2007;
28:589–e95.
73.
GuPPanLLWuSQ, et al.
CA 125, PET alone, PET-CT, CT and MRI in diagnosing recurrent ovarian carcinoma: a systematic review and meta-analysis. Eur J Radiol2009;
71:164–174.
