Positron emission tomography defines metastatic disease but not locoregional disease in patients with malignant pleural mesothelioma Journal Article
| Authors: | Flores, R. M.; Akhurst, T.; Gonen, M.; Larson, S. M.; Rusch, V. W. |
| Article Title: | Positron emission tomography defines metastatic disease but not locoregional disease in patients with malignant pleural mesothelioma |
| Abstract: | Background: Computed tomography and magnetic resonance imaging often fail to predict resectability in patients with malignant pleural mesothelioma. Small studies suggest that fluorodeoxyglucose-positron emission tomography may improve staging. We analyzed our experience to determine more definitively the potential utility of fiuorodeoxyglucose-positron emission tomography. Methods: Patients with malignant pleural mesothelioma who underwent fluorode-oxyglucose-positron emission tomography scanning were identified from an institutional database. All patients fasted and received a minimum of 10 mCi of F-18-fiuorodeoxyglucose. Whole-body emission studies were acquired, followed by whole-body transmission studies, allowing iterative reconstruction. Blinded review of positron emission tomography scans was performed for clinical staging, which was then correlated with surgical and pathologic findings. Sensitivity and specificity were determined for tumor and nodal status. Results: From 1998 to 2002, 63 patients underwent positron emission tomography scans, 60 preoperatively and 3 to assess disease recurrence after surgery. Increased fiuorodeoxyglucose uptake was seen in all but 1 tumor, which was very early stage (IA). Positron emission tomography findings yielded sensitivities of only 19% and 11% for tumor and nodal status, respectively. However, a high standard uptake value in the primary tumor correlated with the presence of N2 disease. Positron emission tomography correctly identified supraclavicular N3 or M1 disease in 6 patients. Conclusions: Positron emission tomography does not identify the local extent of tumor or mediastinal nodal metastases reliably but detects extrathoracic metastases, thereby obviating inappropriate thoracotomy. Further studies of the association between tumor standard uptake value and the presence of N2 disease are warranted. |
| Keywords: | adult; human tissue; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; major clinical study; cancer localization; cancer recurrence; cancer staging; nuclear magnetic resonance imaging; positron emission tomography; follow-up studies; magnetic resonance imaging; lymph nodes; neoplasm staging; sensitivity and specificity; radiopharmaceuticals; computer assisted tomography; statistics; image analysis; thoracotomy; tomography, x-ray computed; data base; biopsy; sarcoma; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; carcinoma; predictive value of tests; malignant mesothelioma; pleura mesothelioma; mesothelioma; new york; false positive reactions; pleural neoplasms; image reconstruction; thoracic surgical procedures; tomography, emission-computed; pleura metastasis; thoracic cavity; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 126 |
| Issue: | 1 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2003-07-01 |
| Start Page: | 11 |
| End Page: | 16 |
| Language: | English |
| DOI: | 10.1016/s0022-5223(03)00207-1 |
| PUBMED: | 12878934 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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