title: Additional value of hybrid PET/CT fusion imaging vs. conventional CT scan alone in the staging and management of patients with malignant pleural mesothelioma.
abstract: BACKGROUND
  Despite being a relatively rare disease, the incidence of malignant pleural mesothelioma (MPM) is expected to increase over the next two decades due to the long time interval elapsing between exposure to causative factors, mainly asbestos, and disease onset. Early disease stages have been reported to benefit from radical surgery. In more advanced disease stages, a multimodality treatment, including various combinations of chemotherapy, external radiotherapy and surgery, may provide some favourable results though the prognosis remains poor. In this regard, an accurate pre-treatment staging plays an important role in offering patients a more appropriate therapeutic planning. In some preliminary studies, (18)F-FDG PET has proven to be able to provide useful information for staging purpose, especially for the detection of metastatic spread to lymph nodes and distant sites.
  
  
  METHODS
  In the present study, we investigated 15 consecutive patients with histologically proven MPM by means of conventional 2-mm thickness whole-body CT scan with and without contrast medium in comparison with wholebody (18)F-FDG PET/CT fusion imaging.
  
  
  RESULTS
  (18)F-FDG PET/CT did not provide additional information about the primary tumour (T) compared to CT scan, but identified a higher number of metastatic mediastinal lymph nodes (N) in 6 patients (40% of cases) and unknown metastatic disease to distant sites (M) in 3 patients (20% of cases). On the basis of PET/CT findings, treatment planning was changed in 5 patients (33.3% of cases).
  
  
  CONCLUSIONS
  Our data show that (18)F-FDG PET/CT fusion imaging can play a relevant role in the staging and treatment planning of MPM patients.
authors.affiliation: Nuclear Medicine Service - PET Unit, Policlinico S. Orsola-Malpighi, Bologna University, Bologna, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ambrosini
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Mohsen
authors.initials: M
authors.lastname: Farsad
authors.forename: Paolo
authors.initials: P
authors.lastname: Castellucci
authors.forename: Roberto
authors.initials: R
authors.lastname: Franchi
authors.forename: Mario
authors.initials: M
authors.lastname: Fabbri
authors.forename: Lucia
authors.initials: L
authors.lastname: Rampin
authors.forename: Giorgio
authors.initials: G
authors.lastname: Crepaldi
authors.forename: Adil
authors.initials: A
authors.lastname: Al-Nahhas
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*