Integrated computed tomography-positron emission tomography in patients with potentially resectable malignant pleural mesothelioma: Staging implications

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Presentation transcript:

Integrated computed tomography-positron emission tomography in patients with potentially resectable malignant pleural mesothelioma: Staging implications Jeremy J. Erasmus, MD, Mylene T. Truong, MD, W. Roy Smythe, MD, Reginald F. Munden, DMD, MD, Edith M. Marom, MD, David C. Rice, MD, Ara A. Vaporciyan, MD, Garrett L. Walsh, MD, Bradley S. Sabloff, MD, Lyle D. Broemeling, PhD, Craig W. Stevens, MD, PhD, Katherine M. Pisters, MD, Donald A. Podoloff, MD, Homer A. Macapinlac, MD The Journal of Thoracic and Cardiovascular Surgery Volume 129, Issue 6, Pages 1364-1370 (June 2005) DOI: 10.1016/j.jtcvs.2004.10.034 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Coronal computed tomography (CT) (A), positron emission tomography (PET) (B), and integrated CT-PET (C) show diffuse uptake of [18F]-fluoro-2-deoxy-d-glucose (FDG) in primary left pleural tumor and focal area of increased uptake in the abdomen (arrow) localized to an abdominal lymph node. Biopsy confirmed nodal metastasis, precluding patient from extrapleural pneumonectomy (EPP). L, Liver. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1364-1370DOI: (10.1016/j.jtcvs.2004.10.034) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Coronal CT (A), PET (B), and integrated CT-PET (C) show diffuse uptake of FDG in primary left pleural tumor and focal areas of increased uptake in the pelvis localized to right iliac bone and left femoral neck. These occult metastases were not detected on conventional staging evaluation. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1364-1370DOI: (10.1016/j.jtcvs.2004.10.034) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Sagittal CT (A), PET (B), and integrated CT-PET (C) show diffuse uptake of FDG in malignant pleural mesothelioma (MPM). Multiplanar reconstruction is useful in evaluating diaphragm and shows normal diaphragmatic contour (white arrowheads) and focal lobular irregularity (black arrowheads) suspicious for transdiaphragmatic extension of tumor. Laparoscopic biopsy confirmed T4 disease. S, Spleen. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1364-1370DOI: (10.1016/j.jtcvs.2004.10.034) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions