Radiological Evaluation Criteria For Malignant Pleural Mesothelioma. Comparison of CT and MRI
A. Knuuttila, M. Halme, L. Kivisaari, L. Tammilehto, K. Mattson. Univ. Central Hospital, Helsinki, Finland.
Malignant pleural mesothelioma grows by plate-like extension invading adjacent tissues and organs and forming pleural effusion. Computed tomography (CT) plays a major role in the diagnosis, although it may not always distinguish malignant tissue and lymph nodes from reactive changes. Selected cases benefit from surgery and chemotherapy, therefore accurate staging is of great importance for planning the treatment. New MRI techniques where surface imaging techniques are combined with quick breath-holding sequences and gadolinium contrast medium give images, which detect tumor growth in the pleura and thoracic wall better than the previous methods. Evaluation criteria for mesothelioma staging by MRI should also be established. We have started a study in which we are investigating both CT and MRI in patients with histologically proven pleural mesothelioma. Imaging is performed before operative procedures and during follow-up. Staging is also performed at thoracoscopy/thoracotomy and these findings are compared to the CT an MRI findings. The study started in September 1996 and during two years we expect to evaluate 25-30 patients. So far MRI seems to allow more accurate evaluation of the extent of the malignant tissue and to have greater sensitivity in the detection of malignant mediastinal lymph nodes than CT.
[This abstract has been summarized]