Ambrosini Valentina, Rubello Domenico, Nanni Cristina, Farsad Mohsen, Castellucci Paolo, Franchi Roberto, Fabbri Mario, Rampin Lucia, Crepaldi Giorgio, Al-Nahhas Adil, Fanti Stefano
Nuclear Medicine Service - PET Unit, Policlinico S. Orsola-Malpighi, Bologna University, Bologna, Italy.
Nucl Med Rev Cent East Eur. 2005;8(2):111-5.
Despite being a relatively rare disease, the incidence of malignant pleural mesothelioma (MPM) is expected to increase over the next two decades due to the long time interval elapsing between exposure to causative factors, mainly asbestos, and disease onset. Early disease stages have been reported to benefit from radical surgery. In more advanced disease stages, a multimodality treatment, including various combinations of chemotherapy, external radiotherapy and surgery, may provide some favourable results though the prognosis remains poor. In this regard, an accurate pre-treatment staging plays an important role in offering patients a more appropriate therapeutic planning. In some preliminary studies, (18)F-FDG PET has proven to be able to provide useful information for staging purpose, especially for the detection of metastatic spread to lymph nodes and distant sites.
In the present study, we investigated 15 consecutive patients with histologically proven MPM by means of conventional 2-mm thickness whole-body CT scan with and without contrast medium in comparison with wholebody (18)F-FDG PET/CT fusion imaging.
(18)F-FDG PET/CT did not provide additional information about the primary tumour (T) compared to CT scan, but identified a higher number of metastatic mediastinal lymph nodes (N) in 6 patients (40% of cases) and unknown metastatic disease to distant sites (M) in 3 patients (20% of cases). On the basis of PET/CT findings, treatment planning was changed in 5 patients (33.3% of cases).
Our data show that (18)F-FDG PET/CT fusion imaging can play a relevant role in the staging and treatment planning of MPM patients.
尽管恶性胸膜间皮瘤（MPM）是一种相对罕见的疾病，但由于接触致病因素（主要是石棉）与疾病发作之间的时间间隔较长，预计在未来二十年中其发病率将会上升。据报道，早期疾病阶段可从根治性手术中获益。在疾病的更晚期，包括化疗、外照射放疗和手术的各种组合的多模式治疗可能会带来一些较好的结果，尽管预后仍然很差。在这方面，准确的治疗前分期对于为患者提供更合适的治疗方案起着重要作用。在一些初步研究中，（18）F-FDG PET已被证明能够为分期提供有用信息，特别是用于检测转移至淋巴结和远处部位的情况。
在本研究中，我们对15例经组织学证实为MPM的连续患者进行了研究，采用常规2毫米层厚的全身CT扫描（有无对比剂），并与全身（18）F-FDG PET/CT融合成像进行比较。
与CT扫描相比，（18）F-FDG PET/CT未提供关于原发肿瘤（T）的额外信息，但在6例患者（占病例的40%）中发现了更多的纵隔转移淋巴结（N），在3例患者（占病例的20%）中发现了未知的远处转移疾病（M）。根据PET/CT检查结果，5例患者（占病例的33.3%）的治疗方案发生了改变。
我们的数据表明，（18）F-FDG PET/CT融合成像在MPM患者的分期和治疗方案制定中可发挥重要作用。
