High-resolution imaging is one of the most important tools for a clinician. A new report in the AME Surgical Journal shows the importance of better clinical imaging. It is key for accurate diagnosis and staging of malignant mesothelioma.
Malignant pleural mesothelioma is a complex disease. Mesothelioma diagnosis and accurate staging are often difficult to pin down. And the diagnosis is further complicated by different disease subtypes.
Higher resolution diagnostic imaging plays an important role in diagnosis and staging. It shows tumor thickness or volumetric data. Future updates to the cancer staging system may use clinical imaging benchmarks.
Importance and Use of Clinical Imaging
Mesothelioma causes significant morbidity and mortality. And it remains a challenging disease to diagnose and stage accurately. It is particularly hard as the different subtypes can behave differently. Yet the accurate diagnosis of subtypes and staging is very important. This is important for making treatment decisions.
Asbestos exposure causes malignant pleural mesothelioma. But it can take many decades from exposure to diagnosis. This long latency period makes exposure tracking a challenge. This can lead to a late diagnosis and a poor prognosis.
Tools like CT or MRI imaging can help with mesothelioma diagnosis, staging, and treatment planning. They give doctors a non-invasive way to look inside the body. CT is more common than MRI. But MRI imaging provides more information than a CT scan.
Most patients present with symptoms such as shortness of breath, chest pain, and a cough. So, more often than not, these patients often receive a CT scan as the first step toward diagnosis. If the CT scan suggests mesothelioma, a biopsy is often the next step.
A biopsy is important for diagnosis and for creating a treatment plan. PET scans have also been useful in determining the spread of the disease. And MRI scans have been a tool in determining if a tumor is able to be surgically removed.
Understanding Staging and Diagnosis
Staging is the process of determining how advanced a patient’s cancer is. It involves looking at various different factors and assigning a rating between 0 and 4. A higher stage indicates more extensive cancer.
International staging guidelines try to optimize care for mesothelioma patients.
The current classification system is in its eighth edition. The International Mesothelioma Interest Group (IMIG) publishes the staging guidelines for malignant pleural mesothelioma.
The latest edition has a few changes from previous guidelines. Previous editions focused on the surgical management of the disease. The latest guidelines highlight the importance of higher-resolution imaging.
The Future of Staging
Malignant pleural mesothelioma remains a challenge to diagnose and treat. The increased combination of advanced imaging choices will likely aid in diagnosis and staging. Future staging guidelines for malignant pleural mesothelioma will likely focus on imaging.
Dr. Sean Jordan of the University of Tennessee says, “Advancements in diagnosis will predictably go hand-in-hand with more precise staging systems that will overall improve prognostication and survival.”
Diagnostic techniques may affect future treatment options. A high-resolution diagnostic imaging is important in diagnosis and staging. And future updates to the staging system may include some of this image data.
Jordan, Sean, Lindsay Nitsche, and Sai Yendamuri. “Narrative review of staging and diagnosis of malignant pleural mesothelioma.” AME Surgical Journal (2022). https://cdn.amegroups.cn/journals/pbpc/files/journals/11/articles/57545/public/57545-PB5-5306-R3.pdf