Case Author(s): David A. Hillier, M.D., Ph.D. and Farroqh Dehdashti, M.D. , . Rating: #D2, #Q3

Diagnosis: Mesothelioma

Brief history:

61 year-old man with left pleural thickening.


PET study

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View second image(pt). PET coronal slices

View third image(xr). Chest radiograph

Full history/Diagnosis is available below

Diagnosis: Mesothelioma

Full history:

61 year-old man with left mesothelioma. Evaluate extent of disease.


15 mCi fluorodeoxyglucose, IV



- Intense activity in pleura of left hemithorax. The extent of disease was better defined by FDG-PET, when the PET results compared with histopathological findings.

2. Follow up chest radiograph (3 weeks later):

- Status post pneumonectomy.


PET can be used to diagnose malignant mesothelioma and define the extent of disease. Computed tomography cannot be used to definitively distinguish malignant mesothelioma from benign diffuse pleural thickening. In a report by Bénard et al, FDG-PET was shown to be useful in differentiating malignant mesothelioma (24/28) from benign pleural lesions (4/28). The FDG uptake was significantly higher in malignant than benign lesions (mean SUV = 4.9 ± 2.9 and 1.4 ± 0.6, respectively; p<0.0001). In addition the extent of disease can be more reliably determined on FDG-PET compared with CT. Lymph node involvement was noted on FDG-PET in 12 patients, 9 of which appeared normal on CT.


1. Baas P and Zoetmulder FAN. Malignant pleural mesothelioma. Ann Oncol 1998; 9:139-149.

2. Bénard, François, et al. Metabolic imaging of malignant pleural mesothelioma with fluorodeoxyglucose positron emission tomography. Chest 1998; 114:713-722.


The patient underwent pneumonectomy.

ACR Codes and Keywords:

References and General Discussion of PET Tumor Imaging Studies (Anatomic field:Lung, Mediastinum, and Pleura, Category:Neoplasm, Neoplastic-like condition)

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Case number: pt026

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