Imaging in pleural mesothelioma: A review of the 11th International Conference of the International Mesothelioma Interest Group

Abstract

Imaging plays an important role in the detection, diagnosis, staging, response assessment, and surveillance of malignant pleural mesothelioma. The etiology, biology, and growth pattern of mesothelioma present unique challenges for each modality used to capture various aspects of this disease. Clinical implementation of imaging techniques and information derived from images continue to evolve based on active research in this field worldwide. This paper summarizes the imaging-based research presented orally at the 2016 International Conference of the International Mesothelioma Interest Group (iMig) in Birmingham, United Kingdom, held May 1-4, 2016. Presented topics included intraoperative near-infrared imaging of mesothelioma to aid the assessment of resection completeness, an evaluation of tumor enhancement improvement with increased time delay between contrast injection and image acquisition in standard clinical magnetic resonance imaging (MRI) scans, the potential of early contrast enhancement analysis to provide MRI with a role in mesothelioma detection, the differentiation of short-and long-term Corresponding Author: Samuel G. Armato III, Ph.D., Department of Radiology, The University of Chicago, 5841 South Maryland Ave., MC 2026, Chicago, IL, USA 60637, s-armato@uchicago.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript survivors based on MRI tumor volume and histogram analysis, the response-assessment potential of hemodynamic parameters derived from dynamic contrast-enhanced computed tomography (DCE-CT) scans, the correlation of CT-based tumor volume with the post-surgical tumor specimen weight, and consideration of the need to update the mesothelioma tumor response assessment paradigm.

Imaging in pleural mesothelioma: A review of the 12th International Conference of the International Mesothelioma Interest Group

“…Higher follow-up tumor volumes were indicative of shorter OS (p=0.009, threshold 386 ml). These results were improved relative to tumor ADC values alone [3]. As expected, the results for differentiating between longand short-term PFS were less encouraging, with only kurtosis of the baseline ADC avg histogram and mean of the follow-up ADC low histogram nearing significance (p=0.054 and 0.07, respectively); lower values of both parameters were predictive of shorter PFS.…”

“…The International Mesothelioma Interest Group (iMig) (www.imig.org) holds a biennial conference to which advances in imaging research and clinical applications of imaging technologies have made key contributions [1][2][3][4]. Researchers, clinicians, and radiologists continue to seek ways to expand the capabilities of imaging with the intent of extracting as much anatomic or physiologic information from mesothelioma patients as possible and to apply imaging technologies most appropriately to patient management in both routine practice and clinical trials research.…”

“…Imaging of tumor perfusion with computed tomography (CT) has become routine for some tumors; however, dynamic contrast-enhanced computed tomography (DCE-CT) has only recently been applied to mesothelioma [3]. Investigation of this imaging technique continues with the computation of hemodynamic parameters designed to capture physiologic changes in the tumor that are not necessarily reflected in tumor thickness change.…”

Applications of Magnetic Resonance Imaging of the Thorax in Pleural Diseases: A State-of-the-Art Review

“…Pleural mesothelioma is the most common form; it accounts for 75 % of cases and is prevalent in the sixth and seventh decades of life [11]. Mesothelioma is commonly associated with exposure to asbestos, with an approximate latency of 35-40 years, but is also related to radiotherapy, tuberculosis, and chronic empyema.…”

“…Although CT shows general features that suggest the diagnosis, MRI of the thorax enables superior visualization of anatomical details, due mainly to a higher signal-to-noise ratio, allowing the identification of tumor extension at the transdiaphragmatic level through the chest wall and distinction from concomitant pleural effusion, especially the laminar type ( Fig. 1) [11]. Mesothelioma shows intermediate signal intensity on T1-WI, high or moderately high intensity on T2-WI, and moderate enhancement by gadolinium.…”