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Oncology-Clinical Diagnosis: Solid TumorsClinical Diagnosis-Solid Tumors Posters |
1 Nuclear Medicine, University Hospital, Udine, Italy
1533
Objectives: to study the value of FDG uptake and RI in MPM as a predictor of disease aggressiveness and prognosis.
Methods: 33 pts with MPM [28 epithelioid (Ep), 1 sarcomatoid (S) and 4 mixed tumours (M)], underwent early (1h) (E) and delayed (2h) (D) PET-CT. RI were calculated and compared to our series of 250 lung cancer (LC) and 10 asbestos-related benign pleural thickenings (BPT). Uptake patterns were classified as focal/linear or heterogeneous/diffuse. Results were compared to histology, stage and survival.
Results: Average E-SUV was 7.9; 9.5 in stage III-IV; 6.3 in stage I-II; 17 in S; 10.8 in M; 7.2 in Ep. RI was 16% in MPM primary lesions (16% in Ep and 15% in M-S) and 35% in LN mets, as compared to 28% in LC and 9% in BPT. RI increased over time except in 2 pts with slowly growing Ep. In earlier stages linear or focal uptake patterns were more frequent. Survival inversely correlated to SUV. At 1 year all pts with E-SUV < 10 were alive (73% of them had Ep and 25% M), while those with E-SUV > 10 died before, ms 9 mo. PET-CT, as compared to CT, provided additional information in 15% of primary tumours and 12% of extrathoracic mets. Being RI lower in primary lesions, dual-time imaging helped in differentiating primary tumours from intrapleural or hilar LN mets, and in 21% of pts allowed to locate LN mets missed by CT.
Conclusions: PET-CT improves MPM staging and dual time imaging can clarify doubtful findings regarding LN involvement and pleural abnormalities. Highest SUVs were associated with shortest survival times.
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