Role of Magnetic Resonance Enterography for Predicting Peritoneal Cancer Index

Study Overview
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Brief Summary
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This is a prospective observational study which will recruit 90 participants over a three-year period to investigate whether adding magnetic resonance imaging and enterography to routine computed tomography study can better predict the extend of peritoneal carcinomatosis over computed tomography alone.

Detailed Description
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Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a new option for patients with peritoneal carcinomatosis and the effectiveness of HIPEC depends on the extend of disease. Currently, pre-operative imaging peritoneal cancer index (PCI) is used to predict the intraoperative tumor extend and completeness of cytoreduction. However, the investigators' previous study and literature review show that imaging PCI usually underestimated intraoperative PCI, resulting in subsequent Open-Close operation. The investigators hypothesize that magnetic resonance imaging (MRI) is a better predictor of the intra-operative PCI than computed tomography (CT), and MR Enterography can better represent tumor deposits in the small intestine. This study aims to test whether the addition of MRI and MR Enterography to CT study improves the prediction performance of the intraoperative PCI and completeness of optimal cytoreduction over CT alone.

Official Title
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Adding Value of Magnetic Resonance Imaging and Magnetic Resonance Enterography for the Pre-operative Assessment of Imaging Peritoneal Cancer Index in Patients With Peritoneal Carcinomatosis

Conditions
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Hyperthermic Intraperitoneal Chemotherapy, Cytoreductive Surgery, Peritoneal Carcinomatosis

Intervention / Treatment
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* Diagnostic Test: MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with peritoneal carcinomatosis diagnosed by computed tomography Schedule for operation at our institute Exclusion Criteria: Age < 20 years old Renal function impairment or acute renal failure Contraindications for magnetic resonance imaging Primary tumor not origins from colorectal cancer, gastric cancer or ovarian cancer

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Magnetic resonance imaging and enterography following computed tomography<br>Magnetic resonance imaging and enterography will be performed after computed tomography but before surgery. | Diagnostic Test: MRI<br>* Magnetic resonance imaging and enterography before surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Predicting intraoperative PCI scores for patients with peritoneal carcinomatosis, using MR Enterography and CT | The Sugarbaker's Peritoneal Cancer Index scores according to the MR enterography and CT images will be calculated pre-operatively and will be compared to the standard PCI scores obtained during operation. Basically, the scoring system divides the abdominopelvic cavity into 13 separate regions, and each region is scored 0-3 points as follows: 0 point, the absence of tumor; 1 point, tumors < 0.5 cm in diameter; 2 points, tumors 0.5-5 cm in diameter; 3 points, tumors > 5 cm in diameter. | 36 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hyperthermic Intraperitoneal Chemotherapy, Cytoreductive Surgery, Peritoneal Cancer Index, Magnetic Resonance Enterography