Preliminary study of positron emission tomography/computed tomography and plasma osteopontin levels in patients with asbestos-related pleural disease

Our plain-English summary of Preliminary study of positron emission tomography/computed tomography and plasma osteopontin levels in patients with asbestos-related pleural disease, by S. Kurata, M. Ishibashi, K. Azuma, et al (Japanese Journal of Radiology, 2010).

The study

• Authors: S. Kurata, M. Ishibashi, K. Azuma, H. Kaida, S. Takamori, K. Fujimoto, M. Kobayashi, Y. Hirose, H. Aizawa, N. Hayabuchi
• Journal: Japanese Journal of Radiology
• Published: 2010;28(6):446-52
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: The aim of this study was to compare the results of semiquantitative analysis by(18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) with plasma osteopontin levels in the same asbestos-related pleural disease population.

Materials And Methods: A total of 17 patients with asbestos-related pleural disease were prospectively recruited. They underwent PET/CT, and plasma osteopontin levels were measured. The maximum standardized uptake value (SUVmax) was determined from the most active pleural lesion in each patient.

Results: Malignant pleural mesothelioma (MPM) was histologically proven in 6 patients, and 11 patients had proven benign asbestos-related pleural diseases (7 pleural plaques, 4 asbestos pleurisy). Significant differences in SUVmax were found between patients with MPM and those with asbestos pleurisy (P = 0.031) and between patients with MPM and those with pleural plaques (P = 0.012). A significant difference was found in the plasma osteopontin levels between patients with asbestos pleurisy and patients with pleural plaques (Bonferroni correction, P = 0.024). The SUVmax in patients with benign asbestos-related diseases was statistically positively correlated with plasma osteopontin in the same group (Spearman's r = 0.75, P < 0.05).

Conclusion: PET/CT might be more helpful than plasma osteopontin for distinguishing benign asbestos-related pleural diseases from MPM, and the SUVmax in benign asbestos-related pleural diseases may reflect changes in pleural inflammation.

In plain English

This preliminary study, by authors at Kurume University in Japan, compared two tests in 17 patients. All had a history of asbestos exposure and were referred for asbestos-related pleural disease and suspected malignant pleural mesothelioma (MPM). Each patient had a PET/CT scan, which measures how strongly a lesion takes up a radioactive sugar tracer (reported as SUVmax), and a blood test for plasma osteopontin. Six patients had MPM confirmed by biopsy, four had asbestos pleurisy and seven had pleural plaques. Median SUVmax was 5.2 in the MPM group, 2.5 in the asbestos pleurisy group and 1.3 in the pleural plaque group, and the MPM group differed significantly from both benign groups. Osteopontin did not differ significantly between the MPM group (median 677 ng/ml) and either benign group. It was significantly higher with asbestos pleurisy (722 ng/ml) than with pleural plaques (289 ng/ml). In the benign patients, SUVmax and osteopontin were positively correlated (Spearman r = 0.75). The authors concluded that PET/CT, rather than osteopontin, might help distinguish these benign diseases from MPM. They noted the small number of patients.

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: Preliminary diagnostic study with prospectively recruited patients, comparing FDG PET/CT uptake (SUVmax) with plasma osteopontin levels
• Who was studied: 17 consecutive patients (median age 69 years, range 50 to 84; 16 men, 1 woman) referred for evaluation of asbestos-related pleural disease and suspected MPM. Final diagnoses were 6 MPM (5 epithelial, 1 biphasic), 4 asbestos pleurisy and 7 pleural plaques. The authors were at Kurume University School of Medicine, Japan. Study dates are not stated.
• Exposure: All patients had a history of asbestos exposure. No fiber type, job or dose is given.
• Main results:
  • Median SUVmax (interquartile range) was 5.2 (4.5 to 13) in the MPM group versus 2.5 (1.7 to 3.2) in the asbestos pleurisy group, a significant difference (Bonferroni-corrected P = 0.031).
  • Median SUVmax in the pleural plaque group was 1.3 (1.0 to 1.5), significantly lower than in the MPM group (P = 0.012). There was no significant difference between the asbestos pleurisy and pleural plaque groups.
  • Median plasma osteopontin was 722 ng/ml (684 to 744) in the asbestos pleurisy group versus 289 ng/ml (250 to 398) in the pleural plaque group, a significant difference (Bonferroni-corrected P = 0.024).
  • Median plasma osteopontin in the MPM group was 677 ng/ml (468 to 1330). This did not differ significantly from either the asbestos pleurisy group or the pleural plaque group.
  • In the 11 patients with benign asbestos-related pleural disease, SUVmax correlated positively with plasma osteopontin (Spearman r = 0.75, P less than 0.05). In the MPM group there was no correlation (r = 0.200, P = 0.747).
• The authors' conclusion: The authors concluded that semiquantitative FDG PET/CT, rather than plasma osteopontin, might be useful for distinguishing asbestos pleurisy and pleural plaques from MPM. They also concluded that SUVmax in the benign groups may reflect chronic inflammation of the pleural lesions.
• Limitations the authors state:
  • Relatively small number of patients, including a small MPM group
  • The range of SUVmax values was limited (the lowest SUVmax in the MPM group was 4.1). The authors noted that some epithelioid MPM patients in earlier reports were missed by PET.
  • Only one biomarker (osteopontin) was evaluated

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Osteopontin, Asbestos-Related Pleural Disease, Pleural Mesothelioma, Pleural Plaques, Pleurisy, Inflammation.

Related studies

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• 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography fused imaging in malignant mesothelioma patients: looking from outside is not enough — E. Roca, S. Laroumagne, et al. (2013)
• Patterns of disease progression on 18F-fluorodeoxyglucose positron emission tomography-computed tomography in patients with malignant pleural mesothelioma undergoing multimodality therapy with pleurectomy/decortication — A. Bille, S. Chicklore, et al. (2013)

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