title: 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography fused imaging in malignant mesothelioma patients: looking from outside is not enough.
abstract: Malignant mesothelioma (MM) is an uncommon neoplasm with a poor prognosis usually associated with asbestos exposure. 18F-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) has become an invaluable tool for the diagnosis, staging, and prognosis of this severe disease as it combines both anatomic and functional information in a single imaging procedure, allowing for improved management of this disease. For many authors, 18F-FDG-PET/CT is the cornerstone of the pre-therapeutic evaluation of mesothelioma patients, particularly when multimodal therapy (including extra-pleural pneumonectomy or omentectomy) is considered. However, while characteristic patterns have been reported as predictive of macroscopic pleural or peritoneal involvement, false negative findings are possible, both for pleural and peritoneal mesothelioma, during the initial diagnosis or during the patient's surveillance as illustrated by this report of three cases of suspected MM with negative PET/CT. This report highlights the limitations of PET/CT in the diagnostic evaluation of MM and the importance of histopathological confirmation by thoracoscopy and/or laparoscopy, which remain the most important diagnostic procedures in MM.
authors.affiliation: Department of Thoracic Oncology, Pleural Diseases, and Interventional Pulmonology, Hôpital Nord, Marseille, France.
authors.forename: Elisa
authors.initials: E
authors.lastname: Roca
authors.forename: Sophie
authors.initials: S
authors.lastname: Laroumagne
authors.forename: Thomas
authors.initials: T
authors.lastname: Vandemoortele
authors.forename: Stéphane
authors.initials: S
authors.lastname: Berdah
authors.forename: Hervé
authors.initials: H
authors.lastname: Dutau
authors.forename: Fabien
authors.initials: F
authors.lastname: Maldonado
authors.forename: Philippe
authors.initials: P
authors.lastname: Astoul
mesh_terms: D000368:Aged; D005188:False Negative Reactions; D019788:Fluorodeoxyglucose F18; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D064847:Multimodal Imaging; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18