mesothelioma study
2
mesothelioma study 2
Preoperative evaluation of patients with malignant pleural
mesothelioma: role of integrated CT-PET imaging.
Truong MT, Marom EM, Erasmus JJ.
Department of Diagnostic Imaging, Unit 57, University of Texas M.D.
Anderson Cancer Center, Houston, TX 77030, USA. mtruong@mdanderson.org
PURPOSE: Malignant pleural mesothelioma (MPM) is an uncommon
neoplasm arising from mesothelial cells of the pleura. The prognosis is poor
with a median survival of 8 to 18 months after diagnosis. Multimodality regimens
combining chemotherapy, radiotherapy, immunotherapy, and surgery are being used
more frequently in patient management. Extrapleural pneumonectomy is the
surgical treatment of choice in 10% to 15% of patients who present with
resectable disease and is reported to prolong survival. Accurate staging is
important to distinguish patients who are resectable from those requiring
palliative therapy. Integrated computed tomography-positron emission tomography
(CT-PET) increases the accuracy of overall staging in patients with MPM and
significantly improves the selection of patients for curative surgical
resection. Specifically, CT-PET detects more extensive disease involvement than
that shown by other imaging modalities and is particularly useful in identifying
occult distant metastases. This article reviews aspects of imaging performed in
the initial staging of patients with MPM according to the International
Mesothelioma Interest Group staging system and will emphasize the appropriate
role of CT-PET imaging in determining the T, N, and M descriptors.