Role of PET/CT in Diagnosis and Staging of Malignant Mesothelioma
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- Category: Vol. 84, December 2016
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Role of PET/CT in Diagnosis and Staging 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 improvements in the diagnosis and accurate staging in malignant mesothelioma. Integration of functional PET data with the anatomical infor-mation of CT has markedly increased the sensitivity, specificity and accuracy of determination of local tumoral extensions, regional lymph nodes or distant visceral metastasis.
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 staging of patients with pathologically proven malignant mesothelioma. A total number of 55 patients (40 male and 15 female) with age range 22-70 (average 55), 47 patients with biopsy proven malignant pleural mesothelioma and 8 patients with biopsy proven malignant peritoneal mesothelioma.
Results: Our study included 55 patients with biopsy proven malignant pleural and peritoneal mesothelioma. All patients had increased FDG uptake in their primary tumor with SUV max (range 4.2-21.7) (mean SVUmax 9.5) at the time of the initial diagnosis. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for PET/CT scan in local tumor (T) staging were 100%, 85%, 98%, 98% and 100% respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for PET/CT scan for nodal (N) staging were 87%, 91%, 89%, 93% and 84% respectively.
The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for PET/CT scan for the distant (M) staging were 98%, 87%, 97%, 98% and 87% respectively.
Conclusion: 18 FDG-PET/CT has proved to be a highly sensitive and specific tool in diagnosis and accurate staging of the disease in patients who proved pathologically to have malignant mesothelioma.