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Mesothelioma
Treatment
Articles
and Abstracts
Prognostic
value of FDG PET imaging in malignant
pleural mesothelioma
J
Nucl Med 1999 Aug;40(8):1241-5
Benard
F, Sterman D, Smith RJ, Kaiser LR, Albelda
SM, Alavi A
Department
of Radiology, University of Pennsylvania
Medical Center, Philadelphia, USA.
Despite
several attempts at treating malignant
pleural mesothelioma with various
modalities, mortality remains high, with
median survival between 12 and 18 mo. This
disease may have a highly variable
clinical course, with occasional long-term
survivors. The purpose of this study was
to assess whether tumor metabolic
activity, as assessed by
fluorodeoxyglucose (FDG) PET imaging,
correlates inversely with survival.
METHODS: Twenty-eight patients with
suspected mesothelioma underwent FDG PET
scanning between September 1995 and May
1997. A diagnosis of mesothelioma was
confirmed in 22. Fully corrected scans
with attenuation correction of the entire
chest were available in 17 patients with
sufficient follow-up for survival
analysis. Standardized uptake values
(SUVs) were determined from the most
active tumor site in each patient.
RESULTS: Seven patients died during
follow-up, at a median period of 5.3 mo
after FDG PET scanning. Follow-up
information was available on the remaining
10 patients for a median period of 15.6 mo
after the PET study. The mean SUV of the
deceased patients was 6.6+/-2.9, compared
with 3.2+/-1.6 among the combined
survivors. The deceased patients had tumor
SUVs that were highly correlated with
duration of survival after the PET study
(r = 0.87, P less than 0.05). The
cumulative survival estimate by the
Kaplan-Meier product limit method was 0.17
at 12 mo for the patients with tumor SUVs
greater than the median value and 0.86 for
those with lower SUVs. The survival
distribution of the high SUV group showed
significantly shorter survivals compared
with the low SUV group (P less than 0.01).
CONCLUSION: Patients with highly active
mesotheliomas on FDG PET imaging have a
poor prognosis. High FDG uptake in these
tumors indicates shorter patient
survival.
PMID:
10450672
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