Imaging Tests for Diagnosis

Doctors use four imaging tests to help them identify mesothelioma. The tests you or your loved one will undergo depend on the symptoms shown. These imaging tests cannot definitively diagnose mesothelioma — only a biopsy can.

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Written by Jenna Campagna, RN

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How Are Imaging Tests Used for Mesothelioma?

Mesothelioma imaging tests are medical procedures used to collect detailed visuals of a patient’s lungs, heart or abdomen. They are essential for doctors to make determinations about the likelihood of mesothelioma as a diagnosis. Doctors also use imaging tests for an early analysis of potential treatment options.

The two most common types of mesothelioma are pleural mesothelioma and peritoneal mesothelioma. All four of these tests can help with either type of the disease. A third, much rarer type is pericardial mesothelioma, which is a cancer of the sac around your heart. For this cancer, you’ll undergo an echocardiogram, which is an ultrasound of the heart.

All types require a mesothelioma biopsy to definitively diagnose a patient.

There are four imaging tests used for mesothelioma. If you suspect you may have this cancer, you will almost certainly undergo one of these tests.

You may even undergo multiple, or all four, of these tests:

  • X-ray
  • Computed tomography (CT) scan
  • Positron emission tomography (PET) scan
  • Magnetic resonance imaging (MRI) scan

The two most common types of mesothelioma are pleural mesothelioma and peritoneal mesothelioma. All four of these tests can help with either type of the disease. A third, much rarer type is pericardial mesothelioma, which is a cancer of the sac around your heart. For this cancer, you’ll undergo an echocardiogram, which is an ultrasound of the heart.

All types require a mesothelioma biopsy to definitively diagnose a patient.

xray
x-ray

X-ray for Mesothelioma

An X-ray uses electromagnetic beams to collect two-dimensional images of the inside of your body. X-rays are used to examine all parts of the body, including the chest and abdomen. This is usually the first imaging test you’ll undergo.

For people who may have mesothelioma, an X-ray helps doctors determine if there is an anomaly in their lungs, abdomen or heart. X-rays of the chest or abdomen can show fluid buildup around the organs. This fluid may also indicate the presence of mesothelioma.

About X-rays for Mesothelioma

  • Pre-procedure: None needed
  • Post-procedure: More images may have to be taken at a later time

What is the procedure time?

Approximately 15 minutes

Does it hurt?

No

ctscan
ctscan

CT Scan for Mesothelioma

A CT scan generates detailed three-dimensional images of specific regions of the body. A CT scan uses X-rays and computer technology to gather multiple images of the same organ at different angles. These images are then merged to create a cross-sectional image of bones, blood vessels and tissue.

The patient lays down on a table as they slowly enter the cylinder, which is commonly referred to as the “donut.” A CT scan helps provide evidence of tumors or tissue abnormalities.

Iodine fluid, or radiocontrast (contrast), may be used to improve visibility within the body on the scans. Patients can either drink the iodine fluid or receive an injection into their veins.

CT scans are the primary imaging technique for a patient with suspected pleural mesothelioma. One study showed pleural thickening was evident in 94% of pleural mesothelioma patients who underwent a CT scan. Pleural effusion occurred in 74% of those patients.

About CT Scans

  • Pre-procedure: Some patients may drink or receive an IV of a contrast liquid so images can be seen clearly
  • Post-procedure: More images may have to be taken at a later time

What is the procedure time?

Between 15 and 60 minutes, with potentially some preparation time needed if the patient will take a contrast fluid

Does it hurt?

No

petscan
petscan

PET Scan for Mesothelioma

A PET scan determines how organs or systems in the body are functioning. They are primarily used to detect the presence of cancers in target areas of the body.

Doctors insert a small dose of a radioactive sugar into the body. Cancerous cells absorb sugar, so this radioactive substance serves as a tracer or identifier. A small camera then takes a picture of the radioactive energy in the body. The cancerous cells appear brighter when the image is collected.

This radiopharmaceutical is usually injected into the bloodstream. Images are collected in the same way CT scans are, through a rotating cylinder that gathers images from all angles.

PET scans can show the presence of tumors and help with staging. The radioactive tracer can show if the cancer has metastasized. Patients can leave and resume their normal day after the test is over. According to one study, PET scans are 89% accurate in distinguishing between malignant mesothelioma and a benign disease.

About PET Scans

  • Pre-procedure: 1 hour before, a radiopharmaceutical material is injected
  • Post-procedure: A second CT scan may be performed to collect more detailed images during a PET scan

What is the procedure time?

Between 45 and 90 minutes, most of which is for the radioactive sugar to travel through your body and be absorbed by cancerous cells

Does it hurt?

No

mriscan
mriscan

MRI for Mesothelioma

A MRI scan creates a complex detailed image of the soft tissue in a specific area. A mesothelioma MRI can reveal the exact location of tumors in tissue.

MRI scans do not involve radiation or X-rays. They use magnets to create the image. MRI scans are primarily used for staging mesothelioma and creating a treatment plan that works best for a specific patient.

Patients lay down a table and slowly enter a cylinder, where a magnetic field is used to gather images. Patients must remain still to provide clear pictures.

About MRI Tests

  • Pre-procedure: None Needed
  • Post-procedure: A second MRI scan may be performed to collect more detailed images

What is the procedure time?

Between 40 and 80 minutes, depending on the size of the area scanned

Does it hurt?

No

Why Are These Tests So Important?

Imaging tests are typically the first step in diagnosing mesothelioma. Patients experiencing symptoms are examined with imaging tests to find evidence of abnormalities in the body.

These tests can reveal the presence of tumors in the patient, but they cannot determine the exact disease or if the tumors are malignant. Further procedures are required to determine if the tumors are mesothelioma.

X-rays and CT scans are the most common imaging tests used for mesothelioma; however, some tests aren’t as effective as others for different types of this cancer. CT scans, for example, aren’t very effective in detecting peritoneal mesothelioma because gas in the intestines can be mistaken for tumors. CT scans are useful for pleural mesothelioma.

While mesothelioma imaging tests are an important diagnostic tool, they aren’t the most important. Seeing a specialist is imperative for patients showing symptoms of mesothelioma.

This disease is hard to diagnose and is often confused with other types of cancer, such as adenocarcinoma or lung cancer. Only a tissue biopsy can confidently diagnose mesothelioma — or rule out the cancer. Connect with a mesothelioma specialist to make sure you get a proper diagnosis.

Last Edited: July 31, 2020.

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