A Role for PET/CT in Response Assessment of Malignant Pleural Mesothelioma

Sandach, Patrick; Seifert, Robert; Fendler, Wolfgang P.; Hautzel, Hubertus; Herrmann, Ken; Maier, Sandra; Plönes, Till; Metzenmacher, Martin; Ferdinandus, Justin

doi:10.1053/j.semnuclmed.2022.04.008

Cited by 7 publications

(5 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have demonstrated the utility of FDG-PET scans in discriminating pleural benign from malignant lesions [26], and current ESMO guidelines support its use especially for patients suited to macroscopic complete resection [27]. Moreover, growing evidence supports the role of FDG-PET/CT scanning in the assessment of response to treatment in patients with MPM, especially during treatment with immune checkpoint inhibitors (ICIs), which have represented a real game changer in the treatment of several malignancies [28][29][30]. According to our experience, all patients had an abnormal FDG-PET avidity value, and lower values were significantly associated with worse diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasound Guided Percutaneous Pleural Needle Biopsy for Malignant Pleural Mesothelioma

Iadevaia,

D’Agnano,

Pagliaro

et al. 2024

JCM

View full text Add to dashboard Cite

Background/Objectives: Ultrasound (US) has been progressively spreading as the most useful technique for guiding biopsies and fine-needle aspirations that are performed percutaneously. Malignant pleural mesothelioma (MPM) represents the most common malignant pleural tumour. Thoracoscopy represents the gold standard for diagnosis, although conditions hampering such diagnostic approach often coexist. The Objective was to determine whether ultrasound-guided percutaneous needle biopsy (US-PPNB) has a high diagnostic accuracy and represents a safe option for diagnosis of MPM. Methods: US-PPNB of pleural lesions suspected for MPM in patients admitted from January 2021 to June 2023 have been retrospectively analyzed. An 18-gauge semi-automatic spring-loaded biopsy system (Medax Velox 2®) was used by experienced pneumologists. The obtained specimens were histologically evaluated and defined as adequate or non-adequate for diagnosis according to whether the material was considered appropriate or not for immunohistochemistry (IHC) analysis. The primary objective of the study was the diagnostic yield for a tissue diagnosis. Results: US-PPNB was diagnostic of MPM in 15 out of 18 patients (sensitivity: 83.39%; specificity: 100%; PPV: 100%). Three patients with non-adequate US-PPNB underwent thoracoscopy for diagnosis. We found significant differences in terms of mean pleural lesion thickness between patients with adequate and not-adequate biopsy (15.4 mm (SD: 9.19 mm) and 3.77 mm (SD: 0.60 mm), p < 0.0010. In addition, a significant positive correlation has been observed between diagnostic accuracy and FDG-PET avidity value. Conclusions: US-PPNB performed by a pneumologist represents a valid procedure with a high diagnostic yield and accuracy for the diagnosis of MPM, and may be considered as an alternative option in patients who are not suitable for thoracoscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasound Guided Percutaneous Pleural Needle Biopsy for Malignant Pleural Mesothelioma

Iadevaia,

D’Agnano,

Pagliaro

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…In our study, all primary lesions were visualized on both 18 F-FDG PET/CT and 68 Ga-FAPI-04 PET/CT. Primary mesothelioma lesions initially start as millimetric multifocal foci and show a sheet-like growth pattern along the pleural space [25]. Due to this unusual growth pattern, the search for volume-based modified specific response criteria instead of RESIST criteria in the evaluation of primary disease has been brought along [26].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the role of 18F-fluorodeoxyglucose PET/computed tomography and 68Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma

Güzel

Kömek

Can

et al. 2023

Nuclear Medicine Communications

View full text Add to dashboard Cite

Objective In this study, we aimed to compare the role of 68 Ga-labeled FAP inhibitor ( 68 Ga-FAPI)-04 PET/ computed tomography (CT) and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma. Materials and methodsOur prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared. ResultsMore lesions were detected in 68 Ga-FAPI-04 PET/CT compared to 18 F-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P = 0.001 and P < 0.001, respectively; lymph node SUVmax and TBR, P = 0.016 and P = 0.005, respectively). With FAPI PET/ CT, upstage was observed according to tumor-nodemetastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin. ConclusionIn addition to the stage change with 68 Ga-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases. Nucl Med Commun

show abstract

“…Furthermore, PET-CT, even though it is not specific enough to routinely identify PM, can be utilized to provide helpful functional information on pleural lesions in cases when prior talc pleurodesis has not been carried out. Indeed, PET-CT during the initial period post talc pleurodesis will enhance due to the inflammatory process of the pleurodesis, but later on (i.e., after 3 months), it can be a useful tool for assessing the extent of the disease and the response to treatment [54]. Based on the standardized uptake value (SUV), PET has shown to be quite useful in differentiating between benign and malignant disorders.…”

Section: Imagingmentioning

confidence: 99%

“…Additionally, the apparently normal pleura may be sampled in a representative manner, and areas of interest may be targeted using thoracoscopic imaging [62][63][64]. Parietal pleural biopsies need to be sufficiently deep to assess the invasion of the chest wall's muscle and fat [54]. VATS may not always be possible because of an obliterated pleural space (e.g., low and loculated effusion) caused by a locally advanced disease.…”

Section: Bioptic Proceduresmentioning

confidence: 99%