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Radiología en Imágenes
Available online 12 June 2024
Carcinomatosis peritoneal, como medirla
How to measure peritoneal carcinomatosis
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A. Mesa Álvareza,
Corresponding author
marina_94_dst@hotmail.com

Autor para correspondencia.
, M. da Silva Torresa, A. Fernández del Vallea, A. Cernuda Garcíab, E. Turienzo Santosc, L. Sanz Álvarezc
a Radiodiagnóstico, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España
b Radiodiagnóstico, Hospital de Cabueñes, Gijón, Asturias, España
c Cirugía General, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España
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Resumen

La carcinomatosis peritoneal (CP) implica la propagación tumoral en el peritoneo, originada tanto por tumores primarios (mesotelioma, carcinoma seroso del peritoneo) como por metástasis de otros órganos (ovario, colon, apéndice, estómago). Aunque antes se consideraba incurable, gracias a las nuevas técnicas como la cirugía citorreductora con quimioterapia intraperitoneal (HIPEC), se han mejorado de forma significativa las perspectivas. Para identificar a los pacientes que se benefician de estos tratamientos el papel del radiólogo es fundamental y se apoyará en técnicas de imagen como la tomografía computarizada (TC), la resonancia magnética (RM) y la tomografía por emisión de positrones (PET/TC). Es necesario conocer las distintas formas de presentación, la forma de cuantificar la carga tumoral (índice de carcinomatosis peritoneal [ICP]) y los criterios de irresecabilidad para una adecuada valoración del estado de la enfermedad. Todo esto debe ser trasmitido y puesto en común en comités multidisciplinares para una actuación óptima y consensuada.

Palabras clave:
Carcinomatosis peritoneal
Quimioterapia hipertérmica intraperitoneal
Tomografía computarizada
Índice de carcinomatosis peritoneal
Abstract

Peritoneal carcinomatosis (PC) is the spread of a tumour in the peritoneum, sometimes originating from a primary tumour (mesothelioma, peritoneal serous carcinoma) and other times arising from a metastasis from another organ (ovary, colon, appendix, stomach). While it was previously considered incurable, significant improvements have been made thanks to new techniques such as cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). Patients who can benefit from these treatments are identified by radiologists who use imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET/CT). It is important to have an awareness of the different forms of presentation, methods of quantifying tumour burden (peritoneal carcinomatosis index, PCI), and criteria for unresectability for an accurate assessment of the disease's status. All this information should be shared and discussed in multidisciplinary boards for optimal and consensus-driven decision-making.

Keywords:
Peritoneal carcinomatosis
Hyperthermic intraperitoneal chemotherapy
Computed tomography
Peritoneal carcinomatosis index

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