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Peritoneal metastasis
Posted: Friday, October 14, 2016 10:40 PM
Joined: 10/14/2016
Posts: 2

1. Can Cyber Knife remove metastasis in the peritoneum?
2. Can Cyber Knife remove very small metastasis? ie. smaller than 10mm, and therefore too small to be visible on a CT scan.

Thank you,

Posted: Saturday, October 15, 2016 4:49 AM
Joined: 10/10/2008
Posts: 4435

Metastatic disease in the peritoneum is usually diffuse and therefore treating with CK is not commonly useful. CK can easily treat things smaller than 10 mm, and does so all the time, but not if they cannot be visualized on some imaging study. It can be a CT, or less commonly another imaging study that can be ACCURATELY fused to a planning CT

Clinton A. Medbery, III, M.D. Southwest Radiation Oncology
Posted: Wednesday, October 19, 2016 8:24 AM
Joined: 10/14/2016
Posts: 2

Dr Medbery,

Many thanks for your reply.

From what I've read, CT and CT/PET scans typically have a resolution of 10mm.  But maybe this has improved recently? Also, I understand MRI scans are higher resolution.

Currently the only way to remove peritoneal metastasis seems to be scraping the peritoneum, followed by HIPEC. (eg. the Sugarbaker method) Do you foresee a time when a very high resolution scan could allow CK to remove numerous 1-3mm metastasis from the peritoneum?

Thank you for your time,

Posted: Wednesday, May 24, 2017 10:44 PM
Joined: 3/8/2017
Posts: 30

Hi Metthew, You are partially correct, the CT/PET scans do have a resolution but they can treat successfully for smaller than 10 mm. HIPEC route is another way to do via scraping the peritoneum.

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