Prognostic value of 18F-FDG PET/CT in patients with malignant pleural mesothelioma.
OBJECTIVE
To evaluate prognostic value of integrated 2-deoxy-2-[F-18]fluoro-D: -glucose-positron emission tomography/computed tomography (FDG-PET/CT) and correlate histopathological subtype with maximum standardized uptake value (SUV(max)) and survival in patients with malignant mesothelioma (MM).


METHODS
Retrospective review of FDG-PET/CT scans, with derivation of SUV(max) of FDG-avid lesions, was performed in patients with biopsy-proven MM. Clinical follow-up and Kaplan-Meier survival analysis was performed.


RESULTS
Forty-six patients (37 M:9 F; mean age 61 years) with MM had a FDG-PET/CT scan in a 30-month period. Follow-up was available on 44/46 (96%) patients. Metastatic disease was detected in 9/46 (20%) patients on FDG-PET/CT, where 8/9 were previously undetected. Better survival was found in patients without metastases (p value < 0.05). Mean SUV(max) of primary pleural lesions in patients with metastatic disease was significantly higher than in patients without metastatic disease (p value < 0.05). Progression-free survival was significantly better in the epithelioid histology group compared to the biphasic group (p value 0.015).


CONCLUSIONS
Detection of extrathoracic metastases on FDG-PET/CT and nonepithelioid histopathology are poor prognostic indicators in patients with MM.
Lee
S T
ST
Centre for PET, Austin Health, Heidelberg, Victoria, Australia. szeting.lee@austin.org.au
Ghanem
M
M
Herbertson
R A
RA
Berlangieri
S U
SU
Byrne
A J
AJ
Tabone
K
K
Mitchell
P
P
Knight
S R
SR
Feigen
M
M
Scott
A M
AM