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Gabelloni M, Faggioni L, Brunese MC, Picone C, Fusco R, Aquaro GD, Cioni D, Neri E, Gandolfo N, Giovagnoni A, Granata V. An overview on multimodal imaging for the diagnostic workup of pleural mesothelioma. Jpn J Radiol 2024; 42:16-27. [PMID: 37676382 PMCID: PMC10764410 DOI: 10.1007/s11604-023-01480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023]
Abstract
Pleural mesothelioma (PM) is an aggressive disease that has a strong causal relationship with asbestos exposure and represents a major challenge from both a diagnostic and therapeutic viewpoint. Despite recent improvements in patient care, PM typically carries a poor outcome, especially in advanced stages. Therefore, a timely and effective diagnosis taking advantage of currently available imaging techniques is essential to perform an accurate staging and dictate the most appropriate treatment strategy. Our aim is to provide a brief, but exhaustive and up-to-date overview of the role of multimodal medical imaging in the management of PM.
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Affiliation(s)
- Michela Gabelloni
- Nuclear Medicine Unit, Department of Translational Research, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy.
| | - Maria Chiara Brunese
- Diagnostic Imaging Section, Department of Medical and Surgical Sciences and Neurosciences, University of Molise, 86100, Campobasso, Italy
| | - Carmine Picone
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131, Naples, Italy
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013, Naples, Italy
| | - Giovanni Donato Aquaro
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126, Pisa, Italy
| | - Nicoletta Gandolfo
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, 16149, Genoa, Italy
| | - Andrea Giovagnoni
- Department of Radiology, University Hospital "Azienda Ospedaliera Universitaria Delle Marche", 60126, Ancona, Italy
- Department of Clinical, Special and Dental Sciences, Università Politecnica Delle Marche, 60126, Ancona, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131, Naples, Italy
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2
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Falanga F, Rinaldi P, Primiceri C, Bortolotto C, Oneta O, Agustoni F, Morbini P, Saracino L, Eleftheriou D, Sottotetti F, Stella GM. Feasibility and safety of extended pleurectomy/decortication for malignant pleural mesothelioma. A single group experience. Thorac Cancer 2022; 13:2792-2798. [PMID: 36052736 PMCID: PMC9527178 DOI: 10.1111/1759-7714.14627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022] Open
Abstract
Surgery is part of a multimodal therapeutic approach to malignant pleural mesothelioma (MPM) although its real beneficial effect is still controversial. The optimal precise sequence of treatments within the trimodality is unclear, and should be decided upon a multidisciplinary consensus for each individual patient. Here, we analyzed the perioperative data of 19 MPM patients who underwent extended pleurectomy/decortication (EPD) with curative intent. The mean age at diagnosis was 67 years; 11 males and eight females. Ten patients were diagnosed with MPM via medical thoracoscopy (MT), and nine via video‐assisted thoracoscopic surgery (VATS). The vast majority of cases harbored epitheliod forms. We compared neoadjuvant chemotherapy (NCT) followed by surgery (11 cases) versus surgery followed by adjuvant chemotherapy (ACT, 8 cases) within a 3‐year period. All patients had extended pleurectomy/decortication and none had an extended pneumonectomy. Analysis of survival curves suggested that the short‐term outcomes are better with upfront EDP followed by ACT if compared to EDP preceded by NCT. Although limited, the data highlighted the safety and feasibility of EPD, with manageable postoperative complications and no major burden for the patients.
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Affiliation(s)
- Francesco Falanga
- Department. of Intensive Medicine, Unit of Cardiothoracic Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Pietro Rinaldi
- Department. of Intensive Medicine, Unit of Cardiothoracic Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Cristiano Primiceri
- Department. of Intensive Medicine, Unit of Cardiothoracic Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Chandra Bortolotto
- Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia Medical School, Pavia, Italy.,Department of Intensive Medicine, Unit of Radiology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Olga Oneta
- Department of Medical Sciences and Infective Diseases, Unit of Radiation Therapy, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Francesco Agustoni
- Department of Intensive Medicine, Unit of Medical Oncology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Patrizia Morbini
- Department of Molecular Medicine, University of Pavia Medical School, Pavia, Italy.,Unit of Pathology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Laura Saracino
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | | | | | - Giulia Maria Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.,Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy
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3
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Saracino L, Bortolotto C, Tomaselli S, Fraolini E, Bosio M, Accordino G, Agustoni F, Abbott DM, Pozzi E, Eleftheriou D, Morbini P, Rinaldi P, Primiceri C, Lancia A, Comoli P, Filippi AR, Stella GM. Integrating data from multidisciplinary Management of Malignant Pleural Mesothelioma: a cohort study. BMC Cancer 2021; 21:762. [PMID: 34210265 PMCID: PMC8252222 DOI: 10.1186/s12885-021-08532-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/23/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural layers. MPM has a strong association with asbestos, mainly caused by exposure to its biopersistent fibers in at least 80% of cases. Individuals with a chronic exposure to asbestos might develop disease with a 20-40-year latency with few or no symptoms. Such has been the case in the Italian regions of Piedmont and Lombardy, where industrial production of materials laden with asbestos, mainly cements, has been responsible for the onset of a large epidemic. Since 2018, a multidisciplinary team at San Matteo hospital in Pavia has been collecting data on over 100 patients with MPM. The main goal of this project is to define and describe an integrated profile for each MPM case at diagnosis by using data mining and partition analysis. METHODS Here we bring together exhaustive epidemiologic, histologic and radiologic data of 88 MPM patients that came to our observation and draw correlations with predictive and prognostic significance. RESULTS The median overall survival (OS) was 15.6 months. Most patients presented with pleural effusion, irrespective of disease stage. Quite unexpectedly, no statistically significant association was demonstrated between OS and TNM disease stage at diagnosis. Although average OS is similar in male and female patients, partition analysis of data underlined a significant differential hierarchy of predictor categories based on patient gender. In females with no smoking history, full chemotherapeutic regimens are associated with better outcomes. Moreover, concerning second line treatments, vinorelbine emerged as the most advantageous choice for female patients, whereas in the male subgroup no statistically significant difference resulted between gemcitabine and vinorelbine. CONCLUSION A multidisciplinary approach to MPM is mandatory to define better therapeutic approaches, personalize the management and improve patient outcomes.
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Affiliation(s)
- Laura Saracino
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Chandra Bortolotto
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Stefano Tomaselli
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Elia Fraolini
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Matteo Bosio
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Giulia Accordino
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Francesco Agustoni
- Department of Medical Sciences and Infective Diseases, Unit of Oncology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - David M Abbott
- Department of Anesthesia and Intensive Care, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Emma Pozzi
- Department of Medical Sciences and Infective Diseases, Unit of Oncology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | | | - Patrizia Morbini
- Department of Molecular Medicine, Unit of Pathology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Pietro Rinaldi
- Department of Intensive Medicine, Unit of Cardiothoracic Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Cristiano Primiceri
- Department of Intensive Medicine, Unit of Cardiothoracic Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Andrea Lancia
- Department of Medical Sciences and Infective Diseases, Unit of Radiation Therapy, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Patrizia Comoli
- Cell Factory and Pediatric Hematology-Oncology Unit, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Andrea R Filippi
- Department of Medical Sciences and Infective Diseases, Unit of Radiation Therapy, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Giulia M Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy.
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Liquid Biopsies from Pleural Effusions and Plasma from Patients with Malignant Pleural Mesothelioma: A Feasibility Study. Cancers (Basel) 2021; 13:cancers13102445. [PMID: 34070018 PMCID: PMC8157824 DOI: 10.3390/cancers13102445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Patients with malignant pleural mesothelioma (MPM) often have to wait a long time before receiving a diagnosis. To contribute to the research on this neoplasm, we analyzed various samples of tumor biopsy and the relative liquid biopsies from both plasma and pleural fluid. We tested the possibility of obtaining information about the tumor in a quicker and less invasive way compared to the usual solid biopsy. We performed NGS on blood and tumor samples from patients and obtained a list of somatic mutations. With the digital droplet PCR technique, we tested the respective pleural fluids and plasma for the previously found mutations. We discovered that pleural fluid is a good proxy to obtain the mutational landscape of the MPM. We also tracked tumor DNA in plasma, leading to the idea that this could be used in a clinical setting to perform follow-ups of patients and monitor drug responses. Abstract Background: Malignant pleural mesothelioma (MPM) is a fatal tumor with a poor prognosis. The recent developments of liquid biopsies could provide novel diagnostic and prognostic tools in oncology. However, there is limited information about the feasibility of this technique for MPMs. Here, we investigate whether cancer-specific DNA sequences can be detected in pleural fluids and plasma of MPM patients as free circulating tumor DNA (ctDNA). Methods: We performed whole-exome sequencing on 14 tumor biopsies from 14 patients, and we analyzed 20 patient-specific somatic mutations with digital droplet PCR (ddPCR) in pleural fluids and plasma, using them as cancer-specific tumor biomarkers. Results: Most of the selected mutations could be detected in pleural fluids (94%) and, noteworthy, in plasma (83%) with the use of ddPCR. Pleural fluids showed similar levels of somatically mutated ctDNA (median = 12.75%, average = 16.3%, standard deviation = 12.3) as those detected in solid biopsies (median = 21.95%; average = 22.21%; standard deviation = 9.57), and their paired difference was weakly statistically significant (p = 0.048). On the other hand, the paired difference between solid biopsies and ctDNA from plasma (median = 0.29%, average = 0.89%, standard deviation = 1.40) was highly statistically significant (p = 2.5 × 10−7), corresponding to the important drop of circulating somatically mutated DNA in the bloodstream. However, despite the tiny amount of ctDNA in plasma, varying from 5.57% down to 0.14%, the mutations were detectable at rates similar to those possible for other tumors. Conclusions: We found robust evidence that mutated DNA is spilled from MPMs, mostly into pleural fluids, proving the concept that liquid biopsies are feasible for MPM patients.
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Piacibello E, Cardinale L, Righi L, Sverzellati N, Ardissone F, Veltri A. Correlation between CT findings and thoracoscopic diagnosis in diffuse pleural disease. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020058. [PMID: 32921755 PMCID: PMC7717031 DOI: 10.23750/abm.v91i3.7713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/22/2020] [Indexed: 11/23/2022]
Abstract
Objective: Computed Tomography (CT) is considered part of the routine diagnostic workup for pleural malignancy. The definitive diagnosis of pleural malignancy depends upon histological confirmation by pleural biopsy. The aim of this study is to assess the sensitivity and specificity of CT, in view of the latest imaging technologies, in detecting pleural malignancy compared to definitive histology achieved via thoracoscopy (VATS). Materials and methods: We included in this retrospective study 90 patients (36 F, 54 M) with suspected pleural malignancy evaluated in our Institution with CT scan who received a definitive diagnosis after VATS biopsy. Unaware of histopathologic diagnoses CT scans were evaluated by a junior and two experts thoracic radiologist. Conclusions were reached by consensus. Results: We evaluated all CT signs suggestive for malignant pleural diseases: pleural thickening > 10 mm (Se 0,41 , Sp 0,79); nodular thickening (Se 0,86, Sp 0,75); circumferential thickening (Se 0,79, Sp 0,69); irregular pleural thickening (Se 0,77, Sp 0,91); mediastinal involvement (Se 0,88, Sp 0,64); costal involvement (Se 0,89, Sp 0,60); diaphragmatic involvement (Se 0,88, Sp 0,53). Furthermore, the diagnostic performance of additional CT features was evaluated: concomitant costal, mediastinal and diaphragmatic pleura lesions (Se 0,84, Sp 0,69); nodular/irregular thickening with mediastinal pleural involvement (Se 0,83, Sp 0,90); nodular/irregular thickening with diaphragmatic pleural involvement (Se 0,81, Sp 0,90). Conclusions: CT confirms its central role in the pleura malignancy. The high sensibility, respect to previous studies, especially in the presence of nodular pleural thickening, may lead to reconsider at least partly the diagnostic pathway of diffuse pleural disease, avoiding the use of VATS in patients not eligible for surgery, in favor of US or CT guided core biopsy. (www.actabiomedica.com)
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Affiliation(s)
- Edoardo Piacibello
- Department of Radiology, S. Luigi Hospital, University of Turin, Turin, Italy.
| | - Luciano Cardinale
- Department of Radiology, S. Luigi Hospital, University of Turin, Turin, Italy.
| | - Luisella Righi
- Department of Oncology, University of Turin at San Luigi Hospital, Turin, Italy. .
| | - Nicola Sverzellati
- Department of Clinical Sciences, Section of Radiology, University of Parma, Parma, Italy.
| | - Francesco Ardissone
- Department of Oncology, Unit of Thoracic Surgery, S. Luigi Hospital, University of Turin, Turin, Italy.
| | - Andrea Veltri
- Department of Radiology, S. Luigi Hospital, University of Turin, Turin, Italy.
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Abbott DM, Bortolotto C, Benvenuti S, Lancia A, Filippi AR, Stella GM. Malignant Pleural Mesothelioma: Genetic and Microenviromental Heterogeneity as an Unexpected Reading Frame and Therapeutic Challenge. Cancers (Basel) 2020; 12:cancers12051186. [PMID: 32392897 PMCID: PMC7281319 DOI: 10.3390/cancers12051186] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 12/18/2022] Open
Abstract
Mesothelioma is a malignancy of serosal membranes including the peritoneum, pleura, pericardium and the tunica vaginalis of the testes. Malignant mesothelioma (MM) is a rare disease with a global incidence in countries like Italy of about 1.15 per 100,000 inhabitants. Malignant Pleural Mesothelioma (MPM) is the most common form of mesothelioma, accounting for approximately 80% of disease. Although rare in the global population, mesothelioma is linked to industrial pollutants and mineral fiber exposure, with approximately 80% of cases linked to asbestos. Due to the persistent asbestos exposure in many countries, a worldwide progressive increase in MPM incidence is expected for the current and coming years. The tumor grows in a loco-regional pattern, spreading from the parietal to the visceral pleura and invading the surrounding structures that induce the clinical picture of pleural effusion, pain and dyspnea. Distant spreading and metastasis are rarely observed, and most patients die from the burden of the primary tumor. Currently, there are no effective treatments for MPM, and the prognosis is invariably poor. Some studies average the prognosis to be roughly one-year after diagnosis. The uniquely poor mutational landscape which characterizes MPM appears to derive from a selective pressure operated by the environment; thus, inflammation and immune response emerge as key players in driving MPM progression and represent promising therapeutic targets. Here we recapitulate current knowledge on MPM with focus on the emerging network between genetic asset and inflammatory microenvironment which characterize the disease as amenable target for novel therapeutic approaches.
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Affiliation(s)
- David Michael Abbott
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
| | - Chandra Bortolotto
- Unit of Radiology, Department of Intensive Medicine, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
| | - Silvia Benvenuti
- Candiolo Cancer Institute, FPO—IRCCS—Str. Prov.le 142, km. 3,95—10060 Candiolo (TO), Italy;
| | - Andrea Lancia
- Unit of Radiation Therapy, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (A.L.); (A.R.F.)
| | - Andrea Riccardo Filippi
- Unit of Radiation Therapy, Department of Medical Sciences and Infective Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy; (A.L.); (A.R.F.)
| | - Giulia Maria Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100 Pavia, Italy;
- Correspondence:
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Arenas-Jiménez JJ, García-Garrigós E, Escudero-Fresneda C, Sirera-Matilla M, García-Pastor I, Quirce-Vázquez A, Planells-Alduvin M. Early and delayed phases of contrast-enhanced CT for evaluating patients with malignant pleural effusion. Results of pairwise comparison by multiple observers. Br J Radiol 2018; 91:20180254. [PMID: 29916720 DOI: 10.1259/bjr.20180254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare images from early and delayed phases of contrast-enhanced thoracic CT for assessing pleural thickening or nodules in a series of patients with malignant pleural effusions. METHODS Blinded images from 36 patients with malignant pleural effusions showing pleural lesions in both early (35 s delayed) and delayed (70 s delayed) phases of thoracic and abdominal contrast-enhanced CT scan were retrospectively assessed by six observers. First, images were individually scored in a six-point scale grading the quality of visualization of pleural findings such as pleural thickening or nodules. This was followed by a paired analysis, where the readers had to choose the one showing the highest quality between two images presented together corresponding to both phases of the same patient showing the same pleural lesion. When possible, contrast attenuation of the abnormal pleura was measured. Statistical analysis was performed by using paired t-test and χ 2. RESULTS Mean attenuation of pleural lesions was significantly higher in the delayed phase (76.0 ± 25.1 vs 57.5 ± 20.7, p < 0.001). Mean score and score of individual images was statistically significant better for the delayed phase for all observers. In the paired analysis, all the readers preferred the delayed phase over the early phase in 77.8 to 91.7% of the cases. CONCLUSION Delayed phase of contrast-enhanced CT is preferable to early phase for evaluating pleural findings. Advances in knowledge: Pleural attenuation is greater for the delayed phase compared with the early phase of contrast-enhanced chest CT. In the pairwise comparison, all the observers prefer the delayed phase over the early phase for pleural evaluation.
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Affiliation(s)
- Juan José Arenas-Jiménez
- 1 Department of Radiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL) - FISABIO Hospital General Universitario de Alicante , Alicante , Spain
| | - Elena García-Garrigós
- 1 Department of Radiology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL) - FISABIO Hospital General Universitario de Alicante , Alicante , Spain
| | | | - Marina Sirera-Matilla
- 2 Department of Radiology, Hospital General Universitario de Alicante , Alicante , Spain
| | - Irene García-Pastor
- 2 Department of Radiology, Hospital General Universitario de Alicante , Alicante , Spain
| | - Alberto Quirce-Vázquez
- 2 Department of Radiology, Hospital General Universitario de Alicante , Alicante , Spain
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Szolkowska M, Blasinska-Przerwa K, Knetki-Wroblewska M, Rudzinski P, Langfort R. Malignant pleural mesothelioma: main topics of American Society of Clinical Oncology clinical practice guidelines for diagnosis and treatment. J Thorac Dis 2018; 10:S1966-S1970. [PMID: 30023092 DOI: 10.21037/jtd.2018.04.106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Malgorzata Szolkowska
- Department of Pathology, The National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | | | - Magdalena Knetki-Wroblewska
- Department of Lung Cancer and Chest Tumors, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute, Warsaw, Poland
| | - Piotr Rudzinski
- Clinics of Surgery, The National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Renata Langfort
- Department of Pathology, The National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
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