Shingo Moriya MD, Presenter: Nothing to Disclose

Noboru Oriuchi MD, Abstract Co-Author: Nothing to Disclose

Yukiko Arisaka MD, Abstract Co-Author: Nothing to Disclose

Akie Takano MD, Abstract Co-Author: Nothing to Disclose

Tetsuya Higuchi MD, PhD, Abstract Co-Author: Nothing to Disclose

Makoto Amanuma MD, Abstract Co-Author: Nothing to Disclose

Keiko Koyama MD, PhD, Abstract Co-Author: Nothing to Disclose

Keigo Endo MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

Malignant pleural mesothelioma (MPM) is an aggressive neoplasm, which has a poor prognosis; although a novel treatment has shown effectiveness to a certain extent. FDG-PET is potentially useful for the differential diagnosis of pleural thickening and the assessment of extent of the tumor in MPM. The aim of the present study was to explore the role of FDG-PET for the diagnosis of MPM. Evaluation of response to therapy and prediction of prognosis by means of FDG-PET were also examined.

Fifteen patients with pleural thickening who had past history of the exposure to asbestos were included in the study. All patients had histological proof or cytopathological diagnosis of presence or absence of MPM and underwent FDG-PET. Quantitative analysis was done by computing the maximal standardized uptake value (SUV) of the FDG accumulation in the lesion, showing highest accumulation of FDG on the attenuation-corrected images. In patients with MPM, chemotherapy or surgical treatment was performed followed by the response evaluation using routine procedure with CT and FDG-PET.

All patients with MPM showed increased uptake of FDG in the lesion, although the intensity was variable (SUV, 2.1-12.6; 5.9±3.1). In contrast, patients with benign pleural thickening did not show increased uptake (SUV, 1.0-2.3; 1.6±0.48) . Statistical analysis showed a significant difference between SUV in patients with MPM and benign pleural thickening. Chemotherapy including chemothermotherapy and chemoradiotherapy was done in 7 out of 9 patients and the other two patients were surgically treated. Response according to radiologic criteria was partial response (PR) in 2 patients, stable disease (SD) in 4 patients, and progressive disease (PD) in 3 patients. Average SUVs of PR, SD, and PD patients were 3.3, 4.2, and 8.4, respectively. Time to progression (TTP) of patients with PR was 5 years and 4 months, respectively; however, TTP was shorter than 6 months in all three patients with SD.

FDG-PET could detect MPM lesions and differentiate from benign pleural thickening in patients with asbestosis. FDG-PET may be also useful for the prediction of response and survival of patients with MPM.

FDG-PET is useful for the differential diagnosis of pleural thickening in patients with asbestosis. FDG-PET may be useful for the prediction of response and survival of patients with MPM.

Moriya, S, Oriuchi, N, Arisaka, Y, Takano, A, Higuchi, T, Amanuma, M, Koyama, K, Endo, K, et al, 0, Differential Diagnosis and Assessment of Prognosis in Malignant Pleural Mesothelioma with 18F-FDG-PET.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015166.html