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Published on: December 21, 2019
Clinical utility of 18F-FDG positron emission tomography in malignant peritoneal mesothelioma
Anna Domènech-Vilardell1, Michael J Rasiej, Robert N Taub
1Department of Nuclear Medicine, University Autònoma de Barcelona, Hospital de la Santa Creu i de Sant Pau, Barcelona, Spain - 38369adv@gmail.com.
Background:
The purpose of this study was to determine the utility of 18F-FDG-PET for evaluating the presence and the extent of malignant peritoneal mesothelioma (MPM), for disease surveillance/recurrence detection and for evaluating response to therapy.
Methods:
We retrospectively analyzed clinical and imaging data of 60 MPM patients (34 women and 26 men, mean age 53.6 y, range 18-80 y) who had multiple 18F-FDG-PET/CT or PET scans (18F-FDG scans) at various stages of the disease.
Results:
Eleven patients had baseline pretreatment scans and all 11 scans showed 18F-FDG avid diffuse, nodular or mixed disease distribution patterns characteristic of MPM. Four patients out of eleven had an early post-treatment 18F-FDG scan (<6 months) and all scans were accurate in determining response to treatment. Forty-nine patients with a history of treated MPM without baseline scans had multiple disease surveillance 18F-FDG scans. Their initial 18F-FDG scans had an accuracy of 82% and positive predictive value of 83% and negative predictive value of 80% for the detection of disease presence and disease-free state, respectively. For fifteen patients with a true negative 18F-FDG scan, a second follow-up scan accurately detected disease recurrence or absence of recurrence in all cases. Metastatic or remote nodal disease was more common in the biphasic histopathologic subtype group while pleural disease was predominantly seen in the epithelial MPM group. No relationship was found between the uptake pattern and the histopathologic subtype.
Conclusion:
18F-FDG-PET is a valuable imaging modality in the pre-surgical evaluation and management of MPM and further prospective studies are warranted.
Insights
18F-FDG-PET imaging is valuable for diagnosing malignant peritoneal mesothelioma (MPM), assessing its extent, and monitoring treatment response and recurrence. This diagnostic tool aids in the pre-surgical evaluation and ongoing management of MPM patients.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer.
- Accurate staging and monitoring are crucial for effective MPM management.
Purpose of the Study:
- To evaluate the utility of 18F-FDG-PET scans in MPM.
- Assess diagnostic accuracy for presence, extent, and recurrence.
- Determine efficacy in monitoring treatment response.
Main Methods:
- Retrospective analysis of 60 MPM patients.
- Inclusion of 18F-FDG-PET/CT or PET scans at various disease stages.
- Review of baseline, post-treatment, and surveillance scans.
Main Results:
- Baseline scans accurately identified MPM characteristics.
- Post-treatment scans correctly assessed treatment response.
- Surveillance scans demonstrated high accuracy (82%) for disease detection and recurrence (NPV 80%, PPV 83%).
- Histopathology showed associations between subtype and metastatic patterns.
Conclusions:
- 18F-FDG-PET is a valuable imaging modality for MPM.
- Useful in pre-surgical evaluation and disease management.
- Further prospective studies are recommended.
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