FDG PET/CT response evaluation in malignant pleural mesothelioma pa-tients treated with talc pleurodesis and chemotherapy

Giovenzio Genestreti, Andrea Moretti, Sara Piciucchi, Noemi Giovannini, Riccardo Galassi, Emanuela Scarpi, Marco Angelo Burgio, Dino Amadori, Stefano Sanna, Venerino Poletti, Federica Matteucci, Giampaolo Gavelli

Research output: Contribution to journalArticlepeer-review


Purpose: Talc pleurodesis (TP) is employed worldwide for the management of persistent pneumothorax or pleural effusion, particularly of malignant origin. However, there are very little available data on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F FDG PET/CT) response evaluation in malignant pleural mesothelioma (MPM) patients treated with TP and chemotherapy. Methods: Patients with histologically confirmed MPM underwent TP and FDG PET/CT staging and restaging after 3-4 courses of chemotherapy. All patients fasted and received a dose of 5.18 MBq 18F-FDG per kilogram of body weight. Whole-body emission scans were acquired with and without Ordered Subset Expectation Maximization (OSEM) iterative reconstruction algorithm. Results: From January 2004 to March 2010, 8 patients with biopsy confirmed MPM (7 epithelial, 1 biphasic), with a median age of 65 years (range: 54-77), were evaluated. Median follow-up was 31 months (range: 4-44). After TP treatment, there was a mean interval of 14 days (range: 9-22) and 125 days (range: 76-162) between FDG PET/CT staging and restaging. According to modified RECIST and EORTC criteria, there was a concordance between the radiologic and metabolic SUVmean and SUVmax responses in 6 (75%) and 3 (37.5%) patients, respectively. Conclusion: TP produces an increased FDG PET uptake which may interfere with the post-chemotherapy disease evaluation. In our case series, the metabolic response measured by SUVmean seems to be in better agreement with the radiologic response compared to the SUVmax.

Original languageEnglish
Pages (from-to)241-245
Number of pages5
JournalJournal of Cancer
Issue number1
Publication statusPublished - 2012


  • F-FDG PET-CT scan
  • Fluorodeoxyglucose
  • Malignant pleural mesothelioma
  • SUV
  • Talc pleurodesis

ASJC Scopus subject areas

  • Oncology


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