Document Detail


Computed tomography, positron emission tomography, positron emission tomography/computed tomography, and magnetic resonance imaging for staging of limited pleural mesothelioma: initial results.
MedLine Citation:
PMID:  18791416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate and compare the role of computed tomography (CT), positron emission tomography (PET), PET/CT, and magnetic resonance imaging (MRI) in the correct staging of patients with limited malignant pleural mesothelioma (MPM). MATERIALS AND METHODS: Fifty-four patients with an epithelial MPM (34 men and 20 women) were included in this study. Patients were referred to our department for staging in a predicted resectable state (stage II/III). Within 3 days, PET/CT and MRI was performed in all patients. Images were evaluated by 3 specialists in the field of PET/CT and MRI. The subexaminations of PET/CT, PET, and CT were independently evaluated with respect to tumor stage. Subexaminations were compared with each other, with MRI and PET/CT. N-stage was verified by mediastinoscopy. Afterward, consensus reading was performed.In 52 patients, surgery served as gold standard. In 2 patients, follow-up control served as gold standard as an inoperable situation with distant metastases was found. Additionally, interobserver variability (kappa value) was calculated. RESULTS: In stage II, accuracy was 0.77 (CT), 0.86 (PET), 0.8 (MRI), 1.0 (PET/CT), and in stage III 0.75, 0.83, 0.9, 1.0. PET/CT was significantly more accurate (P < 0.05) in stages II and III compared with all other techniques. CT and MRI were not able to detect distant metastases in 2 patients, which changed therapy (operable vs. inoperable). Interobserver variability was 0.7, 0.9, 0.8, 1.0 in stage II and 0.9, 0.9, 0.9, 1.0 in stage III. CONCLUSION: PET/CT makes it possible to stage patients with limited MPM with high accuracy and low interobserver variability.
Authors:
Christian Plathow; Adrian Staab; Astrid Schmaehl; Philip Aschoff; Ivan Zuna; Christina Pfannenberg; Schlemmer Heinz Peter; Susanne Eschmann; Michael Klopp
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  43     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-15     Completed Date:  2009-01-07     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  737-44     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, University of Tuebingen, Tuebingen, Germany. christian.plathow@uniklinik-freiburg.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Humans
Karnofsky Performance Status
Magnetic Resonance Imaging / instrumentation*
Male
Mesothelioma / diagnosis*,  physiopathology
Middle Aged
Neoplasm Staging / instrumentation,  methods
Positron-Emission Tomography / instrumentation*
Tomography, X-Ray Computed / instrumentation

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