The use of magnetic resonance imaging in malignant mesothelioma

Our plain-English summary of The use of magnetic resonance imaging in malignant mesothelioma, by J. Entwisle (Lung Cancer, 2004).

The study

• Author: J. Entwisle
• Journal: Lung Cancer
• Published: 2004;45 Suppl 1:S69-71
• Type of article: Review
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Magnetic resonance imaging (MRI) is not routinely used in investigations for patients with suspected malignant pleural mesothelioma but it can be a useful tool in some instances--particularly predicting malignancy in patients with asbestos exposure; differentiating between metastatic pleural disease and malignant pleural mesothelioma (MPM); assessing patients for radical surgery and post treatment evaluation of patients.

In plain English

This short article, by a radiologist at Glenfield Hospital in Leicester, UK, was a review of how magnetic resonance imaging (MRI) is used in malignant pleural mesothelioma. It drew mainly on earlier studies by other researchers. It covered MRI for telling malignant from benign pleural disease in people with asbestos exposure, for staging tumours before radical surgery, and for checking patients after surgery or chemotherapy. The author also briefly reported experience at Leicester. There, 49 patients with epithelioid mesothelioma who were referred for surgery had contrast-enhanced MRI, and in 17 of them it showed unexpected disease that could not be surgically removed. Of the 29 patients who went on to successful radical surgery, three (10.3%) did not have all visible tumour removed. The CT and MRI scans were done an average of 35 days apart (range 0 to 74). The author believed the findings more likely reflected contrast-enhanced MRI being better than CT than tumour growth during that delay. The author concluded that MRI is not routinely used but can be useful in some instances, and proposed that contrast-enhanced MRI is more accurate than MRI without contrast.

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: Narrative review of MRI in malignant pleural mesothelioma, mostly describing other studies, with a brief report of the author's own centre's experience
• Who was studied: For the author's own series: 49 patients with epithelioid malignant pleural mesothelioma (MPM) referred for surgery in Leicester, UK; dates not given
• Exposure: Not an exposure study. The article is about MRI, including contrast-enhanced MRI, compared with CT for imaging malignant pleural mesothelioma. Asbestos exposure is mentioned only as clinical background, and no fiber types are discussed.
• Main results:
  • In the author's series of 49 patients with epithelioid MPM referred for surgery, contrast-enhanced MRI showed unexpected unresectable disease in 17 patients
  • Of the 29 patients in the author's series who underwent successful radical surgery, three (10.3%) did not have complete macroscopic clearance of tumour
  • In the author's series, the average time between CT and MRI scans was 35 days (range 0 to 74)
• The authors' conclusion: The author concluded that MRI is not routinely used for suspected malignant pleural mesothelioma but can be a useful tool in some instances, and proposed that contrast-enhanced MRI is more accurate than unenhanced MRI alone
• Limitations the authors state:
  • The author acknowledged that the long delay between CT and MRI could have allowed tumour progression, though the author believed MRI superiority was the more likely explanation

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: Mesothelioma, Pleural Mesothelioma, Asbestos Exposure.

Related studies

• Asbestos-related pleural disease: value of dedicated magnetic resonance imaging techniques — M.A. Weber, M. Bock, et al. (2004)
• Asbestos-related pericardial thickening detected by magnetic resonance imaging — N.A. Jarad, S.R. Underwood, et al. (1993)
• Early Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy — S. Tsim, C.A. Humphreys, et al. (2018)
• New applications of magnetic resonance imaging for thoracic oncology — Y. Ohno (2014)
• Applications of Magnetic Resonance Imaging of the Thorax in Pleural Diseases: A State-of-the-Art Review — F.M. Pessôa, A.S. de Melo, et al. (2016)
• Magnetic resonance imaging of the thorax in the evaluation of asbestosis — S.I. Bekkelund, U. Aasebø, et al. (1998)

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