18F-Fluorodeoxyglucose PET/CT and dynamic contrast-enhanced MRI as imaging biomarkers in malignant pleural mesothelioma

Abstract

F-FDG PET/CT and DCE-MRI give prognostic information in malignant pleural mesothelioma. Neither PET/CT nor DCE-MRI is useful for monitoring disease progression.

The Prognostic Value of 18F-FDG PET Imaging at Staging in Patients with Malignant Pleural Mesothelioma: A Literature Review

“…Analyzing the full-text version of the remaining 31 studies, there were 12 excluded (4 articles including patients with MPM recurrence); 3 articles from the same referring center; 3 articles including MPM patients with both baseline (pre-treatment) and post-treatment PET, but not reporting prognostic analysis of baseline PET data; 1study with a prognostic analysis performed only in a subgroup population; and 1 article including patients with both peritoneal and pleural mesothelioma, with no separate information on MPM subgroup). Finally, 19 studies were included and analyzed in this review [ 29 , 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

“…Main clinical characteristics of all the included studies are summarized in Table 1 . Regarding the study design, all except two studies [ 34 , 46 ] were retrospective. When considering study population, a heterogeneous sample size was observed, ranging from 23 to 188 patients, with only 5/19 studies enrolling more than 100 patients.…”

“…In this context, selected patients with a homogeneous clinical staging were exclusively analyzed only in three papers [ 29 , 45 , 50 ]. Regarding clinical indications of PET exams, in all the included studies, 18 F-FDG PET imaging was performed for staging purpose (i.e., in MPM patients at first diagnosis) according to the research topic and inclusion criteria of our review: in 17/19 studies, 18 F-FDG PET imaging was exclusively performed at baseline (before any therapy) [ 32 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 47 , 48 , 49 , 50 ]; in the remaining 2/19 studies [ 29 , 46 ], a second PET scan after systemic therapy was performed for treatment response assessment. Information on talc pleurodesis performed before PET scans was available in 13/19 studies; almost half of these studies (6/13) included a cohort of patients submitted to previous talc pleurodesis, ranging from 30% to 50% [ 29 , 32 , 34 , 41 , 44 , 46 ].…”

The F-18 FDG PET/CT and CT evaluation of pleural plaques

“…MR has higher sensitivity and specificity in the discrimination of benign and malignant pleural disease; 98-100% and 92-93% respectively (6). In a recent study comparing the results of FDG PET/CT and dynamic contrast enhanced MRI in the evaluation of malignant pleural mesothelioma have showed that prognostic information regarding overall survival might be predicted by SUV max levels while MRI washout curve shape is related with overall survival as well (7). Another prospective study with the patients with diagnosis of unresectable malignant pleural mesothelioma showed that SUV max is correlated with progression free and overall survival and chemoterahy response potential (8).…”

Pleural biopsies in undiagnosed pleural effusions; Abrams vs image-guided vs thoracoscopic biopsies

“…PET-CT may also be a useful tool for identifying potential biopsy sites. Baseline metabolic activity on PET-CT appears to correlate with survival in mesothelioma [48]. Abrams biopsies are associated with low diagnostic yields and significant complications, and should be avoided where possible.…”