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Clinical utility of FDG-PET/CT for post-surgery surveillance of malignant pleural mesothelioma – Comparison with contrast-enhanced CT

OBJECTIVES: To assess the diagnostic accuracy of fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings for recurrent malignant pleural mesothelioma (MPM) after a radical surgery procedure and their impact on clinical management in comparison with contrast-enhanc...

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Detalles Bibliográficos
Autores principales: Kitajima, Kazuhiro, Hashimoto, Masaki, Katsuura, Takayuki, Kondo, Nobuyuki, Minami, Toshiyuki, Kuribayashi, Kozo, Hasegawa, Seiki, Kijima, Takashi, Yamakado, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887579/
https://www.ncbi.nlm.nih.gov/pubmed/31827724
http://dx.doi.org/10.18632/oncotarget.27324
Descripción
Sumario:OBJECTIVES: To assess the diagnostic accuracy of fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings for recurrent malignant pleural mesothelioma (MPM) after a radical surgery procedure and their impact on clinical management in comparison with contrast-enhanced CT. RESULTS: Treatment failure was confirmed in 40 patients. The patient-based area under the receiver-operating characteristic (ROC) curves (AUC)/sensitivity/specificity/accuracy were 0.915/90.0%/80.0%/88.0% for FDG-PET/CT, and 0.805/75.0%/90.0%/78.0% for contrast-enhanced CT, respectively. AUC and sensitivity values were significantly different between the modalities (both p=0.041). Patient-based AUC values for diagnosing locoregional recurrence (ipsilateral hemithoracic recurrence) and distant metastasis, including peritoneal dissemination and lung, bone, muscle, and liver metastasis, were also significantly different (p=0.023 and p=0.035, respectively). The findings of FDG-PET/CT resulted in a change of management for 14 of the 50 patients (28%) by initiating new treatment. Of six patients judged as not having recurrence by contrast-enhanced CT but truly having recurrence based on FDG-PET/CT findings, 4 patients received new treatment due toFDG-PET/CT. METHODS: Fifty patients who underwent radical surgery for MPM received FDG-PET/CT and contrast-enhanced neck/chest/abdomen/pelvis CT examinations for surveillance or suspected recurrence within a 2-week period. Diagnostic ability was determined on a patient and lesion-site basis by 2 experienced examiners, and the modalities were compared using ROC analysis and McNemar test results. Lesion status was determined on the basis of histopathology, radiological imaging and clinical follow-up for longer than 6 months. CONCLUSION: FDG-PET/CT findings were shown to be more accurate for assessing MPM recurrence and more often led to therapy change than contrast-enhanced CT.