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

Jeremy J. Erasmus; Mylene T. Truong; W. Roy Smythe; Reginald F. Munden; Edith M. Marom; David C. Rice; Ara A. Vaporciyan; Garrett L. Walsh; Bradley S. Sabloff; Lyle D. Broemeling; Craig W. Stevens; Katherine M. Pisters; Donald A. Podoloff; Homer A. Macapinlac

doi:10.1016/j.jtcvs.2004.10.034

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

Jeremy J. Erasmus, Mylene T. Truong, W. Roy Smythe, Reginald F. Munden, Edith M. Marom, David C. Rice, Ara A. Vaporciyan, Garrett L. Walsh, Bradley S. Sabloff, Lyle D. Broemeling, Craig W. Stevens, Katherine M. Pisters, Donald A. Podoloff, Homer A. Macapinlac

Research output: Contribution to journal › Article › peer-review

144 Scopus citations

Abstract

Background: Integrated computed tomography-positron emission tomography imaging with coregistration of anatomic and functional imaging data may improve the accuracy of malignant pleural mesothelioma staging. We evaluate the use of integrated computed tomography-positron emission tomography in patients with malignant pleural mesothelioma who are being considered for extrapleural pneumonectomy. Methods: Twenty-nine patients with malignant pleural mesothelioma who were judged to be candidates for extrapleural pneumonectomy after clinical and conventional radiologic evaluation underwent whole-body integrated computed tomography-positron emission tomography and pathologic staging. Two reviewers blinded to the results of clinical and pathologic staging retrospectively evaluated computed tomography, positron emission tomography, and coregistered computed tomography-positron emission tomography images. Staging was performed according to the International Mesothelioma Interest Group TNM staging system. Histopathology and/or results of further radiologic evaluation or follow-up served as the reference standard. Results: Integrated computed tomography-positron emission tomography provided additional information in 11 of 29 patients that precluded extrapleural pneumonectomy. The overall tumor stage was correctly classified in 21 of 29 patients. The tumor stage was correctly determined in 15 of 24 patients, 6 of whom had T4 (nonresectable) disease. The node stage was accurately determined in 6 of 17 patients. Extrathoracic metastases not identified by routine clinical and conventional radiologic evaluation were detected in 7 of 29 patients and were found to be diffuse (n = 2) or solitary (n = 5). Conclusions: Integrated computed tomography-positron emission tomography increases the accuracy of malignant pleural mesothelioma staging and is important in determining the appropriate therapy in patients being considered for extrapleural pneumonectomy.

Original language	English (US)
Pages (from-to)	1364-1370
Number of pages	7
Journal	Journal of Thoracic and Cardiovascular Surgery
Volume	129
Issue number	6
DOIs	https://doi.org/10.1016/j.jtcvs.2004.10.034
State	Published - Jun 2005

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine

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10.1016/j.jtcvs.2004.10.034

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Erasmus, J. J., Truong, M. T., Smythe, W. R., Munden, R. F., Marom, E. M., Rice, D. C., Vaporciyan, A. A., Walsh, G. L., Sabloff, B. S., Broemeling, L. D., Stevens, C. W., Pisters, K. M., Podoloff, D. A., & Macapinlac, H. A. (2005). Integrated computed tomography-positron emission tomography in patients with potentially resectable malignant pleural mesothelioma: Staging implications. Journal of Thoracic and Cardiovascular Surgery, 129(6), 1364-1370. https://doi.org/10.1016/j.jtcvs.2004.10.034

Integrated computed tomography-positron emission tomography in patients with potentially resectable malignant pleural mesothelioma: Staging implications. / Erasmus, Jeremy J.; Truong, Mylene T.; Smythe, W. Roy et al.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 129, No. 6, 06.2005, p. 1364-1370.

Research output: Contribution to journal › Article › peer-review

Erasmus, JJ , Truong, MT, Smythe, WR, Munden, RF, Marom, EM, Rice, DC , Vaporciyan, AA , Walsh, GL , Sabloff, BS, Broemeling, LD, Stevens, CW, Pisters, KM, Podoloff, DA & Macapinlac, HA 2005, 'Integrated computed tomography-positron emission tomography in patients with potentially resectable malignant pleural mesothelioma: Staging implications', Journal of Thoracic and Cardiovascular Surgery, vol. 129, no. 6, pp. 1364-1370. https://doi.org/10.1016/j.jtcvs.2004.10.034

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

abstract = "Background: Integrated computed tomography-positron emission tomography imaging with coregistration of anatomic and functional imaging data may improve the accuracy of malignant pleural mesothelioma staging. We evaluate the use of integrated computed tomography-positron emission tomography in patients with malignant pleural mesothelioma who are being considered for extrapleural pneumonectomy. Methods: Twenty-nine patients with malignant pleural mesothelioma who were judged to be candidates for extrapleural pneumonectomy after clinical and conventional radiologic evaluation underwent whole-body integrated computed tomography-positron emission tomography and pathologic staging. Two reviewers blinded to the results of clinical and pathologic staging retrospectively evaluated computed tomography, positron emission tomography, and coregistered computed tomography-positron emission tomography images. Staging was performed according to the International Mesothelioma Interest Group TNM staging system. Histopathology and/or results of further radiologic evaluation or follow-up served as the reference standard. Results: Integrated computed tomography-positron emission tomography provided additional information in 11 of 29 patients that precluded extrapleural pneumonectomy. The overall tumor stage was correctly classified in 21 of 29 patients. The tumor stage was correctly determined in 15 of 24 patients, 6 of whom had T4 (nonresectable) disease. The node stage was accurately determined in 6 of 17 patients. Extrathoracic metastases not identified by routine clinical and conventional radiologic evaluation were detected in 7 of 29 patients and were found to be diffuse (n = 2) or solitary (n = 5). Conclusions: Integrated computed tomography-positron emission tomography increases the accuracy of malignant pleural mesothelioma staging and is important in determining the appropriate therapy in patients being considered for extrapleural pneumonectomy.",

author = "Erasmus, {Jeremy J.} and Truong, {Mylene T.} and Smythe, {W. Roy} and Munden, {Reginald F.} and Marom, {Edith M.} and Rice, {David C.} and Vaporciyan, {Ara A.} and Walsh, {Garrett L.} and Sabloff, {Bradley S.} and Broemeling, {Lyle D.} and Stevens, {Craig W.} and Pisters, {Katherine M.} and Podoloff, {Donald A.} and Macapinlac, {Homer A.}",

year = "2005",

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doi = "10.1016/j.jtcvs.2004.10.034",

language = "English (US)",

volume = "129",

pages = "1364--1370",

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T1 - Integrated computed tomography-positron emission tomography in patients with potentially resectable malignant pleural mesothelioma

T2 - Staging implications

AU - Erasmus, Jeremy J.

AU - Truong, Mylene T.

AU - Smythe, W. Roy

AU - Munden, Reginald F.

AU - Marom, Edith M.

AU - Rice, David C.

AU - Vaporciyan, Ara A.

AU - Walsh, Garrett L.

AU - Sabloff, Bradley S.

AU - Broemeling, Lyle D.

AU - Stevens, Craig W.

AU - Pisters, Katherine M.

AU - Podoloff, Donald A.

AU - Macapinlac, Homer A.

PY - 2005/6

Y1 - 2005/6

N2 - Background: Integrated computed tomography-positron emission tomography imaging with coregistration of anatomic and functional imaging data may improve the accuracy of malignant pleural mesothelioma staging. We evaluate the use of integrated computed tomography-positron emission tomography in patients with malignant pleural mesothelioma who are being considered for extrapleural pneumonectomy. Methods: Twenty-nine patients with malignant pleural mesothelioma who were judged to be candidates for extrapleural pneumonectomy after clinical and conventional radiologic evaluation underwent whole-body integrated computed tomography-positron emission tomography and pathologic staging. Two reviewers blinded to the results of clinical and pathologic staging retrospectively evaluated computed tomography, positron emission tomography, and coregistered computed tomography-positron emission tomography images. Staging was performed according to the International Mesothelioma Interest Group TNM staging system. Histopathology and/or results of further radiologic evaluation or follow-up served as the reference standard. Results: Integrated computed tomography-positron emission tomography provided additional information in 11 of 29 patients that precluded extrapleural pneumonectomy. The overall tumor stage was correctly classified in 21 of 29 patients. The tumor stage was correctly determined in 15 of 24 patients, 6 of whom had T4 (nonresectable) disease. The node stage was accurately determined in 6 of 17 patients. Extrathoracic metastases not identified by routine clinical and conventional radiologic evaluation were detected in 7 of 29 patients and were found to be diffuse (n = 2) or solitary (n = 5). Conclusions: Integrated computed tomography-positron emission tomography increases the accuracy of malignant pleural mesothelioma staging and is important in determining the appropriate therapy in patients being considered for extrapleural pneumonectomy.

AB - Background: Integrated computed tomography-positron emission tomography imaging with coregistration of anatomic and functional imaging data may improve the accuracy of malignant pleural mesothelioma staging. We evaluate the use of integrated computed tomography-positron emission tomography in patients with malignant pleural mesothelioma who are being considered for extrapleural pneumonectomy. Methods: Twenty-nine patients with malignant pleural mesothelioma who were judged to be candidates for extrapleural pneumonectomy after clinical and conventional radiologic evaluation underwent whole-body integrated computed tomography-positron emission tomography and pathologic staging. Two reviewers blinded to the results of clinical and pathologic staging retrospectively evaluated computed tomography, positron emission tomography, and coregistered computed tomography-positron emission tomography images. Staging was performed according to the International Mesothelioma Interest Group TNM staging system. Histopathology and/or results of further radiologic evaluation or follow-up served as the reference standard. Results: Integrated computed tomography-positron emission tomography provided additional information in 11 of 29 patients that precluded extrapleural pneumonectomy. The overall tumor stage was correctly classified in 21 of 29 patients. The tumor stage was correctly determined in 15 of 24 patients, 6 of whom had T4 (nonresectable) disease. The node stage was accurately determined in 6 of 17 patients. Extrathoracic metastases not identified by routine clinical and conventional radiologic evaluation were detected in 7 of 29 patients and were found to be diffuse (n = 2) or solitary (n = 5). Conclusions: Integrated computed tomography-positron emission tomography increases the accuracy of malignant pleural mesothelioma staging and is important in determining the appropriate therapy in patients being considered for extrapleural pneumonectomy.

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

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