Integrated FDG PET-CT imaging improves staging in malignant pleural mesothelioma.
AIM of this study was to investigate, how often TNM staging is changed in patients with malignant pleural mesothelioma (MPM) by the application of integrated PET-CT compared to computed tomography alone and how often these changes are clinically relevant.


METHODS
We studied 17 patients (68 +/- 6 years, 8 women) with MPM. Integrated PET-CT scan and histological confirmation were performed in all patients.


RESULTS
Final histological diagnosis confirmed 9 epithelial type, 2 sarcomatoid type and 6 biphasic type MPM. Mean standardized uptake value (SUV) was 5.9 +/- 1.9 in epithelial MPM and 15.1 +/- 10.2 in sarcomatoid MPM. CT and PET-CT revealed discordances in 8/17 (47%) patients in TNM classification with 4/8 (50%) being clinically relevant. PET-CT led to downstaging in 5 (29%) and upstaging in 3 (18%) patients. Mean survival time tended to be higher in the subgroup of patients with lower mean SUV.


CONCLUSIONS
PET-CT seems to be a valuable tool in staging of MPM and leads to discordant findings in almost every second patient compared to CT alone. In many cases these differences are clinically relevant and have therapeutic consequences.
Krüger
S
S
Medizinische Klinik I, Universitätsklinikum Aachen, Pauwelstrasse 30, 52057 Aachen, Germany. stkrueger@ukaachen.de
Pauls
S
S
Mottaghy
F M
FM
Buck
A K
AK
Schelzig
H
H
Hombach
V
V
Reske
S N
SN
D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D013902:Radiography, Thoracic; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18