PET-CT in the diagnosis of localized malignant pleural mesothelioma

Our plain-English summary of PET-CT in the diagnosis of localized malignant pleural mesothelioma, by I. Dimarakis, S. Rehman, A. Machaal, et al (Clinical Imaging, 2011).

The study

• Authors: I. Dimarakis, S. Rehman, A. Machaal, R. Shah
• Journal: Clinical Imaging
• Published: 2011;35(6):476-7
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 67-year-old man presented with right-sided chest and shoulder pain. Chest roentgenogram demonstrated a right upper zone shadow. Computed tomography (CT) revealed a pleural mass and adjacent chest wall disease. Image-guided percutaneous biopsy suggested malignant mesothelioma. We describe the use of 18-fluorodeoxyglucose-positron emission tomography (PET-CT) in the diagnosis and management of localized malignant mesothelioma.

Copyright © 2011 Elsevier Inc. All rights reserved.

In plain English

This case report from the Department of Cardiothoracic Surgery at University Hospital South Manchester, UK, describes one patient. A 67-year-old man, a lifelong non-smoker who denied asbestos exposure, had ten weeks of right upper chest and shoulder pain. A chest X-ray showed a shadow in the upper right chest. A CT scan showed a soft tissue mass in the pleura (the lining of the chest) with nearby disease on the outer chest wall. A needle biopsy was highly suspicious of malignant mesothelioma. A PET-CT scan then showed a 4.1×2.9 cm mass on the right chest wall involving the third rib, with a maximum standardized uptake value of 7.9, and no disease elsewhere. At surgery the tumor involved the third and fourth ribs and the lung beneath was normal. The third, fourth and fifth ribs were removed and the chest wall was rebuilt with mesh. Recovery was uneventful apart from a seroma (fluid collection) that was managed conservatively. The tumor was identified as sarcomatoid mesothelioma. The authors wrote that because radical local surgery is considered the treatment of choice for localized mesothelioma, it is pertinent to identify any further disease before surgery.

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: case report
• Who was studied: one 67-year-old man with right upper chest and shoulder pain, treated at University Hospital South Manchester, UK; dates of care not stated
• Exposure: No asbestos exposure reported: the patient denied asbestos exposure and was a lifelong non-smoker. The article studied the use of PET-CT imaging, not an asbestos exposure.
• Main results:
  • CT of the chest showed a pleural soft tissue mass in the upper right lateral chest wall.
  • Image-guided needle biopsy was highly suspicious of malignant mesothelioma.
  • PET-CT showed a 4.1×2.9 cm soft tissue mass on the right lateral chest wall involving the third rib.
  • The mass had a maximum standardized uptake value (SUVmax) of 7.9, and no disease was seen elsewhere on PET-CT.
  • At surgery the third, fourth and fifth ribs were removed, and the chest wall defect was rebuilt with a 10×10 cm marlex mesh.
  • Recovery after surgery was uneventful apart from a seroma that was managed conservatively.
  • Examination of the removed tumor was consistent with sarcomatoid mesothelioma.
• The authors' conclusion: The authors wrote that because radical local resection is considered the treatment of choice for localized malignant mesothelioma, it is pertinent that any further disease be identified before surgery.

Topics

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

Medical terms in this study, explained in our Lexicon: PET-CT, Pleural Mesothelioma, Biopsy, Mesothelioma, Localized Malignant Mesothelioma.

Related studies

• Clinical implications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography at delayed phase for diagnosis and prognosis of malignant pleural mesothelioma — Y. Abe, K. Tamura, et al. (2012)
• The association of 18F-FDG PET/CT parameters with survival in malignant pleural mesothelioma — A. Klabatsa, S. Chicklore, et al. (2014)
• Current evidence base of FDG-PET/CT imaging in the clinical management of malignant pleural mesothelioma: emerging significance of image segmentation and global disease assessment — S. Basu, B. Saboury, et al. (2011)
• FDG PET/CT in the management of primary pleural tumors and pleural metastases — M. Kruse, S.J. Sherry, et al. (2013)
• Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists — R.A. Vicens, M. Patnana, et al. (2015)
• Malignant pleural mesothelioma: role of CT, MRI, and PET/CT in staging evaluation and treatment considerations — M.T. Truong, C. Viswanathan, et al. (2013)

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