Use of imaging in the management of malignant pleural mesothelioma

Clinical Radiology. Volume 60, Issue 12 , December 2005, Pages 1237-1247. Received 26 January 2005; revised 23 May 2005; accepted 25 May 2005. Available online 12 November 2005. [Link]

R.E. Benamorea, M.J. O’Dohertyb and J.J. Entwislea

a) Department of Radiology, University Hospitals of Leicester, Leicester, UK
b) Clinical PET Centre, Guy’s and St Thomas’ Hospital, London, UK

Abstract

Malignant pleural mesothelioma (MPM) is an increasingly prevalent tumour. The death rate associated with MPM is predicted to peak in the next 10 years, although radiologists and clinicians will be encountering cases for the next few decades. Contrast-enhanced CT is an established technique for evaluating suspected malignant pleural disease, but MPM can be reliably diagnosed only by histological sampling. However, even with adequate sampling and the use of immunocytochemistry, histological diagnosis is known to be difficult; definitive diagnosis may involve a combination of clinical presentation, radiological and histological appearances. Percutaneous biopsy is a promising technique for sampling the pleura. In view of its pattern of growth, MPM is a challenging disease to image by any method, and it behaves quite differently from lung cancer. This review aims to highlight the practical aspects of assessing malignant pleural mesothelioma.

Keywords: Mesothelioma; Pleura; Computed tomography; CT; Biopsy