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The Role Of Imaging In Malignant Pleural Mesothelioma
SOURCE: Semin Oncol 2002 Feb;29(1):26-35
Marom EM, Erasmus JJ, Pass HI, Patz EF Jr.
Department of Radiology, Duke University Medical Center, Durham, NC 27710,
USA.
Imaging plays an essential role in the diagnosis, staging, and follow-up
of patients with malignant pleural mesothelioma (MPM). The diagnosis is
often suggested by a unilateral pleural mass with a moderate to large
pleural effusion seen on chest radiographs, but computerized tomography
(CT) is the most frequently used technique for evaluation of the lungs
in patients with MPM. CT not only suggests pulmonary metastases typically
manifested as nodules or masses, but also can demonstrate underlying lung
disease often caused by prior asbestos exposure. Magnetic resonance (MR)
imaging may be helpful in selected patients with potentially resectable
disease to further examine the local extent of tumor.
Imaging with positron emission tomography (PET) using the radionuclide
imaging agent (18)F fluoro-deoxyglucose (FDG) takes advantage of a basic
property of tumor cells, increased glucose metabolism to identify malignant
lesions. PET provides not only anatomic information, especially regarding
mediastinal node metastasis, but also biochemical information about the
lesion. These imaging modalities help triage patients to the most appropriate
diagnostic and treatment options. Following patients after therapy usually
relies on chest radiographs, although CT can more accurately describe
response to therapy. This review will focus on radiologic evaluation in
diagnosing, staging, and follow-up patients with MPM.
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