Comparing the results of F-18 FDG PET-CT, CT and DTPA Aerosol scintigraphy in Malign Pleural Mesothelioma and Asbestosis

Aim: Malign Pleural Mesothelioma (MPM) is the most common cancer type in primer malignancies of pleura which originated from the mesothelial cells of pleura. MPM can be developed by reason of asbestos exposure. In asbestos exposure, some benign and malign lesions consists in pleura and pulmonary parenchyma. These lesions can be showed by imaging methods. In this study, the pleural mass and pleural thickness were imaged with F-18 FDG PET-CT in MPM patients by reason of asbestos exposure. Correlation between calculated tumor SUVmax/ liver SUVmax values, calculated pleural thickness size and capillary epithelial permeability values calculated with DTPA aerosol scintigraphy were evaluated. Also capillary epithelial permeability(KEP) values of the known patients with asbestos exposure and healthy control patient group were compared.Material and Method: Totally 48 patients, 22 of them who underwent PET/CT imaging and diagnosed MPM, 10 benign asbestosis patient diagnosed with thorax CT and clinically and16 healthy patients as control group included in this study. Mean age of MPM patients is 54,55±13,21 (31-83 years old), mean age of benign asbestosis patients is 54,70±5,50 (45-62 years old), and the mean age of the control group is 56,31±582 (43-64 years old). Tc-99m DTPA Aerosol Scintigraphy was applied to the MPM and benign asbestosis patients to determine the parenchymal damage. DTPA aerosol scintigraphy applied, nonsmoker, with no pulmonary patology and with no asbestos exposure healthy patients were evaluated retrospectively as control group.Result: Accumulation of MPM is localized to 3 parts as upper, median and lower, and the correlation values between pleural thickness values of tumor SUVmax/ liver SUVmax of each area and capillary epithelial permeability(KEP) values are evaluated with Pearson correlation test. Between pleural thickness values and tumor SUVmax/ liver SUVmax values , positive correlation (p<0,001) has been assigned and between capillary epithelial permeability(KEP) values and tumor SUVmax/ liver SUVmax values a negative correlation (p<0,001) has been assigned in all 3 areas. Likewise, in all 3 areas a negative correlation(p<0,001) has been assigned between pleural thickness and capillary epithelial permeability(KEP) values. In the comperative evaluation of capillary epithelial permeability(KEP) values of MPM patients, asbestos exposure patients and control group a significant difference has been assigned. MPM patients are evaluated and staged according to International Mesothelioma Interest Group (IMIG). Stage 1-2 are defined as first, and 3-4 are defined as second group. The KEP values of these groups are compared. In the KEP values of the groups, no significant difference has been assigned (p>0,05).