Pleural mesothelioma starts in the thin lining between your chest and lungs. From there, it can grow in any direction: into your chest wall, towards your lungs and heart, up to your neck, or down to your abdomen.
Distant spread of the disease often goes undetected during routine diagnostic procedures, which inhibits accurate staging. Doctors at Baylor St. Luke’s Medical Center believe a laparoscopy is one possible solution.
Three mesothelioma specialists from the cancer center — Dr. Taylor Ripley, Dr. Lorraine Cornwell and Dr. Eugene Choi — authored a study analyzing the benefit of a laparoscopy for pleural mesothelioma staging.
The study is noteworthy because a laparoscopy isn’t a standard biopsy procedure for this type of mesothelioma. It’s more associated with peritoneal mesothelioma, which develops in the lining of the abdomen.
A laparoscopy is a camera-assisted needle biopsy. Doctors remove tissue samples from the abdominal cavity to find tumors.
Up until now, doctors used a combination of positron emission tomography (PET) and computed tomography (CT) scans to stage pleural mesothelioma. These scans can show masses in the abdomen and other areas beyond the lung cavity.
However, the study reveals that PET and CT scans aren’t as reliable as a laparoscopy.
Analyzing Effect of Laparoscopy With Imaging Tests for Staging
Baylor St. Luke’s Medical Center analyzed 187 cases involving laparoscopy. Nearly 90% of patients had both a PET scan and CT scan during the diagnostic process.
Around 17% revealed a “peritoneal disease” from the laparoscopy biopsy. Their pleural mesothelioma had spread to the peritoneum and possibly further into the abdomen.
Among those patients, 77% didn’t register an abdominal cancer from PET and CT scans. The research revealed the PET-CT scan combination was only 68% accurate for staging, with lower effectiveness for noticing peritoneal disease.
“PET-CT has low sensitivity and diagnostic accuracy to identify peritoneal disease in malignant pleural mesothelioma,” the researchers wrote. “(Laparoscopy) as part of preoperative staging defines an important subset of patients with bi-cavitary disease.”
Sources & Author
- Diagnostic Laparoscopy Improves Staging of Malignant Pleural Mesothelioma with Routine PET Imaging. Annals of Thoracic Surgery. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/33275932/. Accessed: 12/09/2020.
Sources & Author