Gallium scanning in peritoneal mesothelioma

Our plain-English summary of Gallium scanning in peritoneal mesothelioma, by R.R. Armas, S.J. Goldsmith (AJR. American Journal of Roentgenology, 1985).

The study

• Authors: R.R. Armas, S.J. Goldsmith
• Journal: AJR. American Journal of Roentgenology
• Published: 1985;144(3):563-5
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Gallium scans in seven cases of pathologically proven primary peritoneal mesothelioma were reviewed and correlated with clinical, radiologic, and surgical findings. Although five patients gave a history of asbestos exposure, only two showed chest film findings typical of asbestosis. Most had abdominal discomfort, ascites, and abdominal masses. Five of the seven had positive gallium scans; three showed a large single focus of uptake and two showed diffuse abdominal uptake. Although these patterns correspond to the two main gross pathologic types described in peritoneal mesothelioma, there was not complete agreement with clinical, radiographic, and surgical findings, and the focal pattern tended to underestimate the extent of the disease. Although gallium uptake can be seen in a variety of other neoplastic and inflammatory conditions, it may be useful in the diagnosis and follow-up of peritoneal mesothelioma.

In plain English

This was a small case series from Mount Sinai Medical Center, New York. The authors reviewed the records of seven patients with pathologically proven primary malignant peritoneal mesothelioma (mesothelioma of the abdominal lining) who had gallium-67 scans, a nuclear medicine imaging test. These seven came from 12 such patients registered between 1975 and 1982. Five reported a history of asbestos exposure. The article does not describe fiber types, products or jobs. Of those five, only two had chest X-ray changes the authors called typical of asbestosis. Five of the seven scans were abnormal: three showed one large focal area of uptake, and two showed diffuse uptake throughout the abdomen. Two scans were entirely normal. In two of the three focal cases, the scan underestimated how far the disease had spread. Both diffuse cases matched diffuse disease found by other methods. The authors concluded that, although gallium was positive in most patients in this small series, its use for diagnosis and staging is limited by its nonspecificity and the tendency of the focal pattern to underestimate disease extent.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective case series (review of tumor registry and nuclear medicine records)
• Who was studied: Seven patients with proven primary malignant peritoneal mesothelioma who had gallium scans, out of 12 patients with peritoneal mesothelioma registered between 1975 and 1982 at Mount Sinai Medical Center, New York. Ages ranged from 33 to 63 years (mean 49). There were five men and two women.
• Exposure: Five of the seven patients gave a history of asbestos exposure. No fiber types, products, jobs or doses are given. The test studied was gallium-67 citrate scanning.
• Main results:
  • Of the five patients with an asbestos exposure history, only two had typical chest radiographic changes of asbestosis: bibasilar fibrosis in one, and pleural thickening and calcification in the other.
  • Five of the seven patients had abnormal gallium scans.
  • Three patients showed a large focal area of increased uptake: in the left upper quadrant in two, and in the epigastrium in the third.
  • Two patients showed diffuse, irregular uptake throughout the abdominal cavity. Both had diffuse involvement on other findings.
  • In two of the three patients with a focal uptake pattern, the gallium scan underestimated the extent of disease.
  • Two of the seven patients had entirely normal scans. The authors said only one of these false negatives could be explained by extensive therapy received before the scan.
  • Clinical findings, gallium scan, radiologic procedures and surgery did not fully agree on the extent of disease.
• The authors' conclusion: The authors concluded that gallium was positive in most patients in this small series, but that its use in diagnosis and staging is limited by its nonspecificity and by the tendency of the focal pattern to underestimate the extent of involvement.
• Limitations the authors state:
  • The series was too small to assess whether gallium is useful for judging response to therapy or prognosis.
  • The gallium uptake patterns are nonspecific and can also be seen in inflammatory conditions and other cancers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Asbestos Exposure, Chest X-Ray, Ascites.

Related studies

• Gallium scanning in differentiating malignant from benign asbestos-related pleural disease — A.S. Teirstein, P. Chahinian, et al. (1986)
• Bronchoalveolar lavage analysis, gallium-67 lung scanning and soluble interleukin-2 receptor levels in asbestos exposure — G.L. Delclos, D.G. Flitcraft, et al. (1989)
• Pulmonary uptake of gallium-67 in asbestos-exposed humans and sheep — R. Bégin, A. Cantin, et al. (1983)
• Gallium-67 citrate imaging studies of the lung — C. Bekerman, P.B. Hoffer, et al. (1980)
• Unexpected gallium uptake in benign pulmonary pathology. Report of two cases — R.G. McLean, D. Choy, et al. (1984)
• Gallium lung scanning and bronchoalveolar lavage in crocidolite-exposed workers — A.A. Hayes, B. Mullan, et al. (1989)

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