Mesothelioma Scans

Some of the most commonly mesothelioma scans used are imaging methods that include:

X-ray, a chest x-ray can reveal pleural effusion (fluid build-up) which is limited to either the right (60%) or left (40%) lung. On occasion, a mass may be seen. Signs of prior non-cancerous asbestos disease, such as pleural plaques or pleural calcification, or scarring because of asbestosis may also be noted.

Computed Tomography (CT), CT scans are also able to define pleural effusion, in addition to pleural thickening, pleural calcification, thickening of interlobular fissures, or possible chest wall invasion. CT, on the other hand, is not able to differentiate between changes associated with benign asbestos disease (pleural disease), or differentiate between adenocarcinoma of the lung which may have spread to the pleura verses mesothelioma. CT scans may also be important in guiding fine needle aspiration of pleural masses for tissue diagnosis.

Magnetic Resonance Imaging (MRI), MRI scans are most frequently used to determine the extent of tumor prior to aggressive treatment. Since they provide images in multiple planes, they are better able to identify tumors as opposed to normal structures. They are also more accurate than CT scans in assessing enlargement of the mediastinal lymph nodes (those lymph nodes which lie between the two lungs), in addition to a clear diaphragmatic surface, both of which play an important role in surgical candidacy.

Positron Emission Tomography (PET), PET imaging is now becoming an important part of the diagnosis and assessment of mesothelioma. While PET scans are more expensive than other types of imaging, and are not always covered under insurance, they are now considered to be the most diagnostic of tumor sites, as well as the most superior in determining the staging of mesothelioma.

CT/PET, for patients who may be candidates for aggressive multimodality treatment (surgery, chemotherapy and radiation), accurate clinical staging is tremendously important. Integrated CT/PET imaging provides a relatively new tool in this respect, and has turn out to be the mesothelioma scan of choice for determining surgical eligibility. By combining the benefits of CT and PET (anatomic and metabolic information) into a single scan, this technology can more precisely determine the stage of the cancer, and can help identify the best treatment option of asbestos disease for the patient.