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PET Valuable for Diagnosing and Staging Mesothelioma

ByAlex Strauss

2151433_body scan2 Positron Emission Tomography (PET) scans are one of the most effective tools for predicting how well a mesothelioma patient will respond to treatment, and for planning that treatment.

That’s the conclusion of a team of British researchers who analyzed 15 different studies comparing PET to other types of tools for diagnosing and staging mesothelioma and for predicting survival and mortality.

Eleven of the studies evaluated the role of FDG-PET (PET scanning using a fluorodeoxyglucose marker). Several of those studies found that malignant mesothelioma cells absorbed more of the FDG marker than healthy cells, making FDG-PET a good method for determining the extent of the mesothelioma. In these studies, patients whose bodies were seen on FDG-PET scan to absorb the most of the FDG marker had the shortest survival time. Similarly, mesothelioma patients on chemotherapy who showed a decline in FDG uptake were found to have a longer time until tumor progression.

One study found that the FDG-PET technology accurately upstaged 13% and downstaged 27% of mesothelioma cases that had been initially staged using computed tomography (CT).

Four of the 15 studies evaluated the role of FDG-PET in combination with CT technology (PET-CT) in the diagnosis and prognosis of malignant pleural mesothelioma. One of these studies found that primary metastatic mesothelioma lesions (tumors that have spread) had a higher absorption of the FDG than non-metastatic cells. Another study comparing PET-CT to PET alone in staging mesothelioma found PET-CT to be more accurate.

The scientists who analyzed all of the PET studies concluded “Overall, PET accurately diagnoses malignant pleural mesothelioma and predicts survival and disease recurrence. It can guide further management by predicting the response to chemotherapy and excluding surgery in patients with extrathoracic disease. Combined PET-CT has additional benefits in accurately staging disease.”

The analysis was published in the journal Interactive Cardiovascular and Thoracic Surgery.

Sources:

Sharif, S et al, “Does positron emission tomography offer prognostic information in malignant pleural mesothelioma?”, Interactive Cardiovascular and Thoracic Surgery, January 25, 2011, Epub ahead of print. Zahid, I et al, “What is the best way to diagnose and stage malignant pleural mesothelioma?”, Interactive Cardiovascular and Thoracic Surgery, November 1, 2011, Epub ahead of print.

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