Abstract：
Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) is the mainstay of potentially curative surgical treatment for malignancies that have spread to peritoneal surfaces. This surgical procedure is however associated with high morbidity and appropriate patient selection and planning is therefore essential. Available multimodality imaging techniques include CT with oral and intravenous contrast, MRI including use of dedicated peritoneal protocol and FDG-PET/CT. These used with the correct technique, read by specialist radiologists and discussed under the auspices of a dedicated multidisciplinary team, can help to improve outcomes. We demonstrate that imaging not only provides information about peritoneal disease burden but more importantly want to shift the reader\'s focus to disease distribution. Our examples highlight how imaging helps avoid futile surgery by identifying patients with disease in unfavourable sites and show the strength and limitations of the various imaging modalities. We share how MR imaging can help identify multifocal and often occult sites including widespread miliary disease. Our examples provide a comprehensive overview demonstrating how imaging can help plan surgery by identifying patients who may need splenic vaccinations, counselling for stoma, egg harvesting and input from surgeons with other specialist expertise greatly increasing likelihood of achieving complete cytoreduction.
摘要：
有或没有腹膜内高温化疗（HIPEC）的细胞减灭术（CRS）是可能治愈性手术治疗已扩散到腹膜表面的恶性肿瘤的主要手段。然而，这种外科手术与高发病率相关，因此，适当的患者选择和计划至关重要。可用的多模态成像技术包括口服和静脉造影的CT，MRI包括使用专用腹膜方案和FDG-PET/CT。这些使用了正确的技术，由专业放射科医生阅读，并在专门的多学科团队的主持下进行讨论，可以帮助改善结果。我们证明，成像不仅提供有关腹膜疾病负担的信息，而且更重要的是要将读者的重点转移到疾病分布上。我们的例子强调了成像如何通过识别不利部位的疾病患者来帮助避免徒劳的手术，并显示了各种成像方式的优势和局限性。我们分享MR成像如何帮助识别多灶性和经常隐匿的部位，包括广泛的粟粒性疾病。我们的例子提供了一个全面的概述，展示了成像如何通过识别可能需要脾疫苗接种的患者来帮助计划手术。造口咨询，卵子收获和外科医生与其他专业知识的投入大大增加了实现完全细胞减少的可能性。
