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The Chicago Consensus Working Group provides the following multidisciplinary recommendations for the care of patients with peritoneal surface malignancies. This article focuses on the standards of a peritoneal surface malignancy center, standards of billing and coding, standards of operative reports for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, standards of cytoreductive surgery training, and standards of intraoperative chemotherapy preparation. These guidelines are developed with input from leading experts including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of ovarian neoplasms specifically related to the management of peritoneal surface malignancy. These guidelines are developed with input from leading experts including surgical oncologists, medical oncologists, gynecologic oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of colorectal cancer specifically as it relates to the management of peritoneal surface malignancy. These guidelines are developed with input from leading experts including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of peritoneal mesothelioma. These guidelines are developed with input from leading experts, including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness of the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of colorectal cancer specifically as it relates to the management of peritoneal surface malignancy. These guidelines are developed with input from leading experts, including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of ovarian neoplasms specifically related to the management of peritoneal surface malignancy. These guidelines are developed with input from leading experts, including surgical oncologists, medical oncologists, gynecologic oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

The Chicago Consensus Working Group provides the following multidisciplinary recommendations for the care of patients with peritoneal surface malignancies. This article focuses on the standards of a peritoneal surface malignancy center, standards of billing and coding, standards of operative reports for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, standards of cytoreductive surgery training, and standards of intraoperative chemotherapy preparation. These guidelines are developed with input from leading experts, including surgical oncologists, medical oncologists, pathologists, radiologists, palliative care physicians, and pharmacists. These guidelines recognize and address the emerging need for increased awareness in the appropriate management of peritoneal surface disease. They are not intended to replace the quest for higher levels of evidence. [ABSTRACT FROM AUTHOR]

Objective: The purpose of our study was to evaluate the utility of single-shot spin-echo echo-planar diffusion-weighted imaging (DWI) using a b value of 400-500 s/mm(2) for depicting peritoneal tumors., Materials and Methods: Thirty-four consecutive oncology patients underwent preoperative abdominal and pelvic MRI for tumor staging. MRI included breath-hold DWI with a b value of 400-500 s/mm(2), T1-weighted spoiled gradient-echo, T2-weighted fast spin-echo, and 0- and 5-minute delayed gadolinium-enhanced imaging. At three separate sessions, two observers independently reviewed images for peritoneal tumors at 16 anatomic sites. First DWI alone was reviewed, followed by conventional MRI alone, and then conventional MRI, including DWI, was reviewed. Results of laparotomy and histopathologic evaluation were compared with MRI results. Sensitivity, specificity, and accuracy were calculated for DWI, conventional MRI, and combined DWI and conventional MRI for peritoneal tumor depiction., Results: Two-hundred fifty-five sites of peritoneal tumor were proven by surgical and histopathologic findings. The combination of DWI and conventional MRI was most sensitive and accurate for peritoneal tumors, depicting 230 and 214 tumor sites for the two observers (sensitivity, 0.90, 0.84; and accuracy, 0.91, 0.88) compared with DWI alone, which depicted 182 and 182 tumor sites with sensitivity (0.71, 0.71; and accuracy, 0.81, 0.81), and conventional MRI alone, which depicted 185 and 132 tumor sites (sensitivity, 0.73, 0.52; and accuracy, 0.81, 0.72). Peritoneal tumor showed restricted diffusion on DWI and ascites was of low signal intensity, increasing tumor conspicuity., Conclusion: Adding DWI to routine MRI improves the sensitivity and specificity for depicting peritoneal metastases. Breath-hold DWI is now routinely used in all oncology patients referred for abdominal MRI at our institution.

Objective: The objective of our study was to determine the accuracy of MRI in the preoperative staging and classification of mucinous appendiceal neoplasms and to describe the MRI features that are useful for selecting patients for surgical resection., Materials and Methods: Twenty-two patients underwent preoperative MRI including T1-weighted, T2-weighted, immediate gadolinium-enhanced, and delayed gadolinium-enhanced imaging. Two observers reviewed the images for peritoneal tumor at 13 sites, tumor size and distribution, and degree of tumor enhancement. Peritoneal tumor sites were recorded at surgery. Cytoreduction was categorized as complete or suboptimal. Surgical specimens were classified as disseminated peritoneal adenomucinosis tumors, intermediate-grade tumors, or peritoneal mucinous carcinomatosis tumors., Results: Surgery confirmed 232 tumor sites. Delayed gadolinium-enhanced MRI was the most accurate of the MR techniques, with a sensitivity, specificity, and accuracy of 89%, 87%, and 89%, respectively, for observer 1 and 82%, 87%, and 83% for observer 2 (p < 0.001). Surgical cytoreduction was complete in 14 patients and suboptimal in eight. MRI findings predicting suboptimal cytoreduction included a large (> 5 cm) mesenteric mass, which was present in 75% of the patients in the suboptimal cytoreduction group and 0% of those in the complete cytoreduction group; diffuse mesenteric tumor (88% and 0%, respectively); tumor encasement of mesenteric vessels (88% and 0%); or diffuse small-bowel serosal tumor (75% and 0%). Histopathology results showed six disseminated peritoneal adenomucinosis tumors, four intermediate tumors, and 11 peritoneal mucinous carcinomatosis tumors. The specimens for the remaining patient were not available for histopathologic analysis. Qualitatively, the 11 peritoneal mucinous carcinomatosis tumors showed greater enhancement than the liver, whereas six disseminated peritoneal adenomucinosis and the four intermediate tumors showed less enhancement than the liver. Quantitatively, the mean tumor-to-liver contrast for disseminated peritoneal adenomucinosis and intermediate tumors was 0.67 compared with 1.53 for peritoneal mucinous carcinomatosis tumors (p < 0.0001)., Conclusion: Of the MR techniques evaluated, delayed gadolinium-enhanced MRI was the most accurate for the staging and classification of mucinous appendiceal neoplasms and provided prognostic information useful for patient selection.