Various modalities have been used in the treatment of MPM. Radiation therapy alone is gener-ally used for palliation (4). Patients who undergo chemotherapy with a platinum- or doxorubicin-containing regimen have shown limited response without significant change in survival time (5). Aggressive surgical resection (extrapleural pneumonectomy or radical pleurectomy-decortication) used alone has also yielded disappointing results, with a median survival time of less than 1 year (6,7). However, multimodality therapy consisting of surgery followed by chemotherapy and radiation therapy has been shown to prolong survival. Sugarbaker et al (8) studied 183 patients who had undergone extrapleural pneumonectomy followed by adjuvant chemotherapy and radiation therapy and found a median survival time of 19 months at the most recent follow-up. More recently, Lee et al (9) showed a median survival time of 18.1 months for patients who had undergone radical pleurectomy-decortication with aggressive radiation therapy with or without chemotherapy. Proper patient selection is crucial in identifying those most likely to benefit from an aggressive multimodality regimen. Imaging studies, including computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), play an essential role in the staging of disease in patients who are potential surgical candidates.
In this article, we discuss and illustrate the staging and diagnostic evaluation of MPM with CT, MR imaging, and PET.
Read More Here : http://pubs.rsna.org/doi/full/10.1148/rg.241035058
Selasa, 07 Februari 2017