Evidence map›Paper›PMID 38836936›Full record

ArticleEmergency radiology2024

ED diagnosis of peritoneal carcinomatosis.

Devorah Scheinfeld, Carly Schwartz, Adam Z Fink

Abstract read
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Article in Emergency radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Devorah ScheinfeldMontefiore Medical Center, Department of Radiology, 111 East 210 Street, Bronx, NY, 10467, USA.
Carly SchwartzDepartment of Radiology, Division of Emergency Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY, 10467, USA.
Adam Z FinkDepartment of Radiology, Division of Emergency Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY, 10467, USA. afink@montefiore.org.ORCID http://orcid.org/0009-0002-9055-544X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe goal of our study was to better characterize new CT diagnoses of peritoneal carcinomatosis (PC) in the ED, and to evaluate how to best identify the primary lesion. Prompt identification of the source of the carcinomatosis may allow for the patient to receive early initial care from the correct clinical service.

methodsAll new CT cases of PC-like appearance identified on CT in the ED from January 2017 through July 2020. Each report and corresponding medical record were manually reviewed. Patient demographics, presence/absence of intravenous contrast, source organ predicted by the radiologist in the CT scan report, pathologic diagnosis, and amount of ascites were tabulated. Chi-tests were used to test the statistical significance of differences between groups.

resultsOf the 131 CT cases of new PC-like appearance which received workup, 108 cases had pathologically proven PC and 23 cases had no underlying malignancy yielding a positive predictive value for actual PC of 82%. The most common cause of new PC in women was gynecological (66%), and in men was of GI tract origin (57%). Concordance between radiologist prediction and final pathology was higher with intravenous contrast (58%) compared to without contrast (40%); although this difference was not statistically significant (p = 0.19). A moderate or large amount of ascites was found in more than half of GYN primaries and in adenocarcinoma of unknown primary and there was a statistically significant difference in amount of ascites between cancer primaries (p = 0.01).

conclusionA PC-like appearance on CT in the ED will likely be in patients with known malignancy, but of the new cases, there is a high PPV for it to represent new peritoneal carcinomatosis. Gynecological and GI malignancies are the most common cause in women and men, respectively, and this may help in focusing the radiologist's search pattern. Usage of intravenous contrast may help in identifying a primary lesion, and the presence of high-volume ascites should suggest a GYN primary or adenocarcinoma of unknown primary when there is no other obvious primary lesion.

Indexed as

Contrast MediaEmergency Service, HospitalPeritoneal NeoplasmsTomography, X-Ray ComputedAdultAgedAged, 80 and overCarcinomaDiagnosis, DifferentialFemaleHumansMaleMiddle AgedRetrospective StudiesContrast MediaAscitesEmergency departmentPeritoneal carcinomatosisPeritoneal malignancy

Identifiers

PMID38836936
PMCPMC11289182

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.