My surgeon, who is part of a surgical group that specialized in HIPEC, told me in one of our earliest consults that scans were somewhat limited in their ability to catch peritoneal activity. I discussed HIPEC with him, and preconsented to it, prior to my colon resection and again prior to my liver resection.
He said that as part of the monitoring process, if my CEA's started to drift up and they couldn't find a smoking gun with scans, that they would do a laparoscopic procedure to take a little camera scope and look around the peritoneum.
The issue with scans is that often peritoneal mets can be small and scattershot and fly below the radar of CT and PET sensitivity. Also they are often surface mets and more disc shaped than orb shaped which makes them easier to miss with scans since they can slip between the slices.
So you might want to ask Wake Forest if that is something they do as part of evaluating your candidacy for the HIPEC protocol.
I want to add that my surgeons are very aggressive, and huge cheerleaders, but in no way have they ever sugarcoated anything for me in terms of prognosis or the reality of a procedure and its potential complications. So if you consult with them you can get some good, hard information. I also had a phone consult shortly after my diagnosis with Dr. Lowy's practice at University of Cincinnatti and I found them to be very helpful and realistic as well. Both of these places may be closer to home for you as well!
Also check out the www.hotchemo.com
forum. You might be able to hook up with some folks who have undergone the procedure.