Marcia M. Santos Dellea MD, Presenter: Nothing to Disclose

Thomas F. Hany MD, Abstract Co-Author: Nothing to Disclose

Monika Jermann MD, Abstract Co-Author: Nothing to Disclose

Marc Küng MD, Abstract Co-Author: Nothing to Disclose

Rolf A. Stahel MD, Abstract Co-Author: Nothing to Disclose

Hans C. Steinert, Abstract Co-Author: Nothing to Disclose

In malignant pleural mesothelioma computed tomography (CT) is used for monitoring tumor response to therapy by measuring the tumor thickness perpendicular to the chest wall at three different levels. Positron emission tomography (PET) using F-18-Fluordeoxyglucose (FDG) provides quantitative and qualitative information about tumor activity and thus allows differentiating necrotic or fibrotic tissue from viable tumor tissue. Functional imaging parameters as standard uptake value (SUV) and total lesion glycolysis (TLG) have been developed for monitoring tumor metabolic changes during therapy. Aim of this study was to compare the results of integrated PET-CT imaging versus CT alone in the treatment response of patients with MPM.

Till now, 17 patients (15 M, 2 F; 37-74 y, average 63y) with histological proven MPM have been analysed. All patients received first line chemotherapy with pemetrexed and cis- or carboplatin. At baseline and after 3 cycles of chemotherapy integrated PET-CT scanning using a combined device (Discovery LS, GE Medical Systems) was performed. SUV max, total lesion glycolysis (TLG) defined as (SUVmax)*(Volume), CT global tumor volume (CTgv) as well as the sum of the longest lesions in three transaxial sections in CT (Ctsum) were determined. Response indices were calculated and statistically compared.

Using the response index of Ctsum, the current standard method using CT, 5 patients had partial remissions and 12 stable disease. Using CTgv or TLG, 7 and 11 patients responded and 1 and 2 patients had progressive disease, respectively. The levels of SUVmax alone (maximal or average) did not correlated with tumor response.

Serial measurement of total tumor glycolysis appears to be the best method to identify patients with MPM responding or not responding to platin-based combination chemotherapy with pemetrexed.

Santos Dellea, M, Hany, T, Jermann, M, Küng, M, Stahel, R, Steinert, H, Malignant Pleural Mesothelioma: Response Evaluation with Integrated PET-CT Imaging.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411513.html Accessed August 26, 2025