Role of PET/CT in Follow-up and Assessment of Therapy Response of Malignant Mesothelioma, AMR O.M.A. AZAB, DALIA I. MOHAMED, SHAHENDA S. SALEM and MOHAMED M. HOUSENI
Abstract
Background: Malignant mesothelioma is a malignancy arising from the coelomic mesodermal lining forming the pleura, peritoneum, pericardium and tunica vaginalis. The disease is causally linked to asbestos exposure.
18-F-FDG-PET/CT has demonstrated significant improve-ments in the assessment of tumor response to the prescribed treatment in malignant mesothelioma.
PET/CT is increasingly used to monitor tumor response in patients undergoing chemotherapy and chemoradiotherapy. PET/CT is used for differentiating residual viable tumor tissue from therapy-induced fibrosis.
Treatment may be adjusted according to the chemosensi-tivity and radiosensitivity of the tumor tissue.
The purpose of this retrospective study is to highlight the beneficial role of PET/CT scan in the assessment of therapy response of patients with pathologically proved malignant mesothelioma therefore determining the optimal treatment and the assessment of therapy response.
Material and Methods: This is a retrospective study carried out in a Private Radiology Center from March 2012 to December 2014 for patients who have done PET/CT scans for therapy assessment in pathologically proven malignant mesothelioma. A total number of 55 patients (40 male and 15 female) with age range 22-70 (average 55). 55 patients pre-sented for initial staging, a number of 50 out of 55 (90%) patients had single follow-up PET/CT study after receiving single or multimodal treatment, 20 out of 50 (40%) patients had >1 follow-up PET/CT.
Results: Mismatch between the morphologic response detected by CE-CT alone and the metabolic response detected by PET/CT in 8 of 50 (16%) patients, while there were match in 42 (84%) patients on subsequent follow-up studies.
Conclusion: 18 FDG-PET/CT has proved to be a highly sensitive and specific tool in in the precise assessment of the therapy response in patients who proved pathologically to have malignant mesothelioma as well as.