Document Detail


Utility of integrated computed tomography-positron emission tomography for selection of operable malignant pleural mesothelioma.
MedLine Citation:
PMID:  19632941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Malignant pleural mesothelioma (MPM) is a primary malignancy characterized by local invasion of the pleura and metastasis. Despite advances in computed tomography (CT) and magnetic resonance imaging (MRI), accurately staging patients remains challenging. Recent studies have examined the use of integrated CT-positron emission tomography (PET) for staging patients. MATERIALS AND METHODS: Mayo Clinic databases were queried to identify cases with a histologic diagnosis of MPM from 2000 to 2006. Inclusion criteria were a diagnosis of MPM, an available CT scan, and an initial staging integrated CT-PET scan. A total of 35 patients were identified who met the inclusion criteria. Computed tomography and integrated CT-PET scans were reviewed by experienced radiologists. Laboratory parameters were reviewed. The Mayo Clinic tumor registry and Social Security database were queried for survival data in patients in which no follow-up was available. RESULTS: Findings on integrated CT-PET excluded 14 of 35 patients from surgical intervention. Extrapleural pneumonectomies (EPPs) were performed in 8 patients, and partial pleurectomies were performed in 2 patients. Upstaging from integrated CT-PET occurred in 70% of the patients when surgical pathology was available, 2 cases to an inoperable stage. Although not statistically significant, median survival was 20 months for patients undergoing an EPP and 12 months for patients excluded from surgical intervention by integrated CT-PET. CONCLUSION: Malignant pleural mesothelioma is a difficult disease to accurately stage. The most common reason for upstaging in our series was an increase in T (tumor; tumor-node-metastasis staging system) disease. Our data suggest that integrated CT-PET is excellent for detecting nodal and distant metastases. However, the ability of this imaging modality to correctly stage locoregional disease is not superior to the combination of CT and MRI as reported in the literature.
Authors:
Brad E Wilcox; Rathan M Subramaniam; Patrick J Peller; Gregory L Aughenbaugh; Francis C Nichols Iii; Marie Christine Aubry; James R Jett
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical lung cancer     Volume:  10     ISSN:  1938-0690     ISO Abbreviation:  Clin Lung Cancer     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-27     Completed Date:  2010-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100893225     Medline TA:  Clin Lung Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-8     Citation Subset:  IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Male
Mesothelioma / radionuclide imaging*,  surgery
Middle Aged
Neoplasm Staging / methods
Pleural Neoplasms / radionuclide imaging*,  surgery
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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