RESEARCH ARTICLE Prognostic Value of 18 F-FDG PET/CT in Patients with Malignant Pleural Mesothelioma

Purpose: To evaluate prognostic value of integrated 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) and correlate histopathological subtype with maximum standardized uptake value (SUVmax) and survival in patients with malignant mesothelioma (MM). Procedures: Retrospective review of FDG-PET/CT scans, with derivation of SUVmax of FDGavid lesions, was performed in patients with biopsy-proven MM. Clinical follow-up and Kaplan– Meier survival analysis was performed. Results: Forty-six patients (37 M:9 F; mean age 61 years) with MM had a FDG-PET/CT scan in a 30-month period. Follow-up was available on 44/46 (96%) patients. Metastatic disease was detected in 9/46 (20%) patients on FDG-PET/CT, where 8/9 were previously undetected. Better survival was found in patients without metastases (p valueG0.05). Mean SUVmax of primary pleural lesions in patients with metastatic disease was significantly higher than in patients without metastatic disease (p valueG0.05). Progression-free survival was significantly better in the epithelioid histology group compared to the biphasic group (p value 0.015). Conclusions: Detection of extrathoracic metastases on FDG-PET/CT and nonepithelioid histopathology are poor prognostic indicators in patients with MM.