title: The role of 18F-FDG-PET/ceCT in peritoneal mesothelioma.
abstract: OBJECTIVE
  The aim of this study was to assess glucose metabolism of multicystic peritoneal mesothelioma and epithelioid peritoneal mesothelioma by fluorine-18 fluorodeoxyglucose (F-FDG)-PET/contrast-enhanced computed tomography (ceCT) and to assess its prognostic impact.
  
  
  METHODS
  Twenty-three (14 women) patients, without previous treatment, underwent F-FDG-PET/ceCT before peritoneal mesothelioma cytoreductive surgery and intraperitoneal chemotherapy. F-FDG-PET/ceCT was interpreted prospectively as positive or negative. Maximum standardized uptake value (SUVmax) of each lesion was measured retrospectively on the basis of postsurgery data. At laparotomy, disease extension was estimated with the Peritoneal Cancer Index. The median follow-up was 27 months (95% confidence interval: 12.9-37.8); progression-free survival (PFS) was recorded.
  
  
  RESULTS
  Nine patients were affected by multicystic and 14 were affected by epithelioid peritoneal mesothelioma. PET showed mild focal uptake in one case of multicystic peritoneal mesothelioma, whereas in eight patients, no abnormal uptake was observed. PET was positive in 12/14 patients with epithelioid peritoneal mesothelioma. Sensitivity, specificity and accuracy were respectively 86, 89 and 87%; the qualitative assessment was statistically different (P=0.0020, χ). Multicystic peritoneal mesothelioma histology was significantly associated with lower SUVmaxlesion (P=0.0061), SUVmaxlesion/liver (P=0.0025), Peritoneal Cancer Index, younger age, and it was observed only in women.Recurrence was observed on nine patients affected by epithelioid peritoneal mesothelioma, whereas no recurrences were observed among multicystic peritoneal mesothelioma patients. SUVmaxlesion (P=0.0278) and age (P=0.0241) were significantly associated with PFS in patients with epithelioid peritoneal mesothelioma.
  
  
  CONCLUSIONS
  F-FDG-PET/ceCT showed significant differences between multicystic and epithelioid peritoneal mesothelioma, whereas SUVmaxlesion was associated with PFS in the latter. Although multicentre prospective studies are necessary, F-FDG-PET/ceCT appears to be a promising tool in patients affected by peritoneal mesothelioma.
authors.affiliation: aNuclear Medicine Departement, Hospices Civils de Lyon, Lyon, France bEquipe Mixte de Recherche 3738, Université Claude Bernard Lyon 1, Lyon, France cLyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France dRadiology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France eDepartment of Nuclear Medicine, and PET/CT Center, Santa Maria della Misericordia Hospital, Rovigo, Italy fGeneral and oncologic surgery Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France gPathology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Dubreuil
authors.forename: Francesco
authors.initials: F
authors.lastname: Giammarile
authors.forename: Pascal
authors.initials: P
authors.lastname: Rousset
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Naoual
authors.initials: N
authors.lastname: Bakrin
authors.forename: Guillaume
authors.initials: G
authors.lastname: Passot
authors.forename: Sylvie
authors.initials: S
authors.lastname: Isaac
authors.forename: Olivier
authors.initials: O
authors.lastname: Glehen
authors.forename: Andrea
authors.initials: A
authors.lastname: Skanjeti
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging* / Q000378:metabolism; D018261:Mesothelioma, Cystic / Q000000981:diagnostic imaging / Q000378:metabolism; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose