Characterizing Omental PET/CT Findings For Differentiating Tuberculous Peritonitis From Peritoneal Carcinomatosis

Objective: To characterize and investigate PET/CT findings in the omentum in the differentiation of tuberculous peritonitis(TBP)and peritoneal carcinoma(PC).Methods: Thirty-nine patients with TBP and 113 patients with PC who underwent PET/CT were retrospectively enrolled.The omentum uptake intensity,distribution characteristics,contracture,size and boundary of soft-tissue lesion,and CT patterns were reviewed.Results: Absent fluorodeoxyglucose(FDG)uptake in the hepatogastric ligament,and hepatoduodenal ligament are more common in PC(P=0.021,P=0.002,respectively);focal FDG uptake in the hepatogastric ligament,and gastrocolic ligament are more common in PC(P=0.021,P=0.022,respectively);diffuse FDG uptake in the hepatogastric ligament,hepatoduodenal ligament,and gastrocolic ligament are more common in TBP(P<0.001,P<0.001,P=0.001);and these distribution characteristics in the free-hanging portion were not significantly different between TBP and PC(all P>0.05).Apron-like pattern is more common in TBP(P=0.004).Micronodular(<5 mm)is more common in TBP(P<0.001);mass(>3 cm)is more common in PC(P=0.001).Smudge and nodular patterns are more common in TBP(P<0.001,P=0.003);Caked pattern is more common in PC(P<0.001).There was no significant difference in the uptake intensity and boundary of soft-tissue lesion between TBP and PC.Conclusions: This study characterized omental PET/CT findings for differentiating TBP and PC.