FDG PET-CT Results Could Lead to Improved Mesothelioma Treatment

In a recent study, researchers say a better understanding of certain diagnostic criteria could result in more targeted treatments for malignant mesothelioma.

In a recent published report, doctors from the medical school at Dicle University in Diyarbakir, Turkey measured the relationship between PET-CT scan results and survival in 177 patients with malignant pleural mesothelioma. The patients were diagnosed between April 2007 and April 2011. They had a mean age of 55.4 and most (56%) were male. Patients in the study all had FDG PET-CT scans before beginning their mesothelioma treatment.

FDG PET-CT scanning is a powerful imaging tool for mesothelioma and other cancers that combines a radioactive tracer with a combination of positron emission tomography and computed tomography scanning.  Because it is a glucose analog, the FDG tracer is taken up in a larger amount by cells with a higher rate of metabolism, which includes the majority of cancer cells. While the FDT PET scan produces an image of cellular activity, the CT scan creates a three dimensional image of a tumor by assembling multiple radiographic ‘slices.’ Together, the two tests can give doctors valuable information about a patient’s mesothelioma.

When the FDG-PET/CT results of the 177 Turkish patients were analyzed, it revealed the following data about mesothelioma prognosis.

•    Men with mesothelioma were 5.3 times more likely to have a poor prognosis than woman.

•    Having a performance score (a measure of overall health) less than 60 meant the mesothelioma patient was more than twice as likely to have a poor prognosis.

•    Patients on “best supportive care” (symptom management only) were 25.4 times more likely to have a poor prognosis.

•    Patients with stage III or IV mesothelioma, meaning the mesothelioma has spread to distant lymph nodes or beyond, increased poor prognosis by approximately 11 times.

•    A standardized uptake value (a measure of how much of the radioactive tracer is taken up by cells) greater than 5 increased a poor prognosis 4.34 times.

The report concluded that these factors, revealed by FDG PET-CT,  are all “significant predictors of survival” in mesothelioma. The authors suggest that studying them may help research scientists improve treatment for this hard-to-treat cancer. The report summary concludes, “An understanding of the importance of these markers for malignant pleural mesothelioma prognosis should allow targeted treatments to be developed.”

Source:

Abakay, A, et al, “relationship between 18 FDG PET-CT findings and the survival of 177 patients with malignant pleural mesothelioma”, May 2013, European Reviews for Medical and Pharmacological Sciences.