11. Evaluation of Patients with Known Mesothelioma with 18F-Fluorodeoxyglucose and PET. Comparison with Computed Tomography.

Purpose: Positron Emission Tomography (PET) using 18F-Fluorodeoxyglucose (18FDG) has been extensively used to stage patients with different malignancies. The purpose of our study was to compare 18FDG-PET to Computed Tomography (CT) in the management of patients with malignant mesothelioma.Methods: Eight patients (6 males, 2 females; mean age 67, range 53 to 78 years) underwent 18FDG-PET scan between March 1997 and November 1998. PET scan of the neck, thorax and upper abdomen was performed 45 minutes after the intravenous injection of 10 mCi of FDG in fasted patients; attenuation correction was applied in all cases. The findings were compared with CT and pathology.Results: PET and CT were concordant in 3 patients. PET was superior to CT in 5 cases (1 patient was downgraded from widespread to localized disease, 2 patients were upstaged from localized to widespread disease, PET confirmed equivocal findings by CT in 2 cases). In 1 patient PET and CT missed local spread of tumor to diaphragm and pericardium, showing instead disease confined to pleural space.Conclusions: Our results suggest that PET is more accurate than CT in the staging of patients with mesothelioma.