PET/CT Scan Challenge Of Pleural Effusion Treatment For Mesothelioma Patients

Early detection of the fatal and incurable mesothelioma and the subsequent provision of radiation, surgical and palliative asbestosis treatments are known to help a patient to have the best possible chance to extend and improve the quality of life remaining.

Crucial to the process is the use of body scanning technologies, ranging from X-rays, MRI (Magnetic Resonance Imaging), CT (computed tomography) or CAT scans, and the more advanced PET/CT (positron emission tomography and computerized tomography).

The long gestation period of up to 50 years from first asbestos exposure and inhaling of the fibre dust to the appearance of asbestosis symptoms can often mean that a diffuse malignant mesothelioma has reached an advanced stage and spread to other organ tissues.

While X-rays of chest or abdomen can detect fluid build-up, masses, or signs of non-cancerous pleural disease, evidence of diffuse cancerous growths by radiology will only show as a shadow formed by a single tumour, as with peritoneal mesothelioma. Similarly, despite MRI supplying a highly detailed image of the interior body and can determine the severity of a tumour, this type of scan is still unable to clearly indicate a cancerous growth.

CT scans produce images, which provide a cross section examination of layers of the body to more easily reveal abnormalities at a given depth within the body and can also accurately diagnose lung cancer sooner than chest x-rays, leading to an increased survival rate by up to 20 per cent. However, while CT scans are able to define pleural effusion, pleural thickening, pleural calcification or possible chest wall invasion, they cannot differentiate between benign or malignant mesothelioma.

Mesothelioma patients who suffer painful breathing caused by pleural effusions – the build-up of fluid across the lung linings in response to the spread of mesothelioma tumours – can undergo a procedure for the draining of the fluid and replacing the space with medical talc.

New medical research has found that the fluid draining process may interfere with the PET/CT monitoring, which also involves injecting the patient with a radioactive tracer and the level of absorption by cancer cells subsequently measured by the scan, once after 14 days and then again after 125 days.

It was discovered that by increasing the amount of tracer absorbed by cancer cells, the talc treatment can appear to show the disease is spreading more rapidly than its real progress.

The researchers concluded that to compensate for the interference with the evaluation, a slightly modified way of interpreting the scan results is advised for mesothelioma patients who receive pleural draining and talc treatments.

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