Imaging Scans

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MR Imaging

In patients with potentially resectable disease, MR imaging can provide additional staging information. Use of different pulse sequences and
gadolinium-based contrast material can help differentiate between tumor and normal tissue. Relative to adjacent chest wall muscle, MPM is typically
iso- or slightly hyperintense on T1-weighted images and moderately hyperintense on T2-weighted images. MPM enhances with use of gadolinium-based contrast material. The excellent contrast resolution of MR imaging can allow improved detection of tumor extension, especially to the chest wall and diaphragm, and better prediction of overall resectability. Anatomic and morphologic MR imaging features similar to those seen at CT are used to establish local invasion of MPM. Loss of normal fat planes, extension into mediastinal fat, and tumoral encasement of more than 50% of the circumference of a
medi-astinal structure are some of the MR imaging features that suggest tumor extension.
A recent study showed that MR imaging is superior to CT in revealing two types of invasive growth of MPM: invasion of the diaphragm and invasion of
endothoracic fascia or a single chest wall focus . MR imaging is most useful in evaluating patients with questionable areas of local tumor extension at
CT or in whom intravenous administration of iodinated contrast material is contraindicated.

Imaging Tests

Chest x-ray: This may show irregular thickening of the pleura, calcium deposits on the pleura, or fluid in the pleural space. These findings suggest asbestos exposure leading to the development of a mesothelioma.
Imaging studies such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans will help determine the location, size, and extent of the cancer.

Computed tomography (CT): The CT scan is an X-ray procedure that produces detailed cross-sectional images of your body. Instead of taking one picture,like a conventional x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body. The machine will take pictures of multiple slices of the part of your body that is being studied.

CT scans are often used to make the initial diagnosis of malignant mesothelioma, and are helpful in staging the cancer (determining the extent of its spread).

Often after the first set of pictures is taken you will receive an intravenous injection of a "dye" or radiocontrast agent that helps better outline structures in your body. A second set of pictures is then taken.CT scans are more tiring than regular x-rays because they take longer and you need to lie still on a table while they are being done. But just like other computerized devices, they are getting faster and your stay might be pleasantly short. Also, you might feel a bit confined by the ring you lie within when the pictures are being taken.You will have an IV (intravenous) line through which the contrast "dye" is injected. The injection can also cause some flushing (redness and warm feeling).
Some people are allergic and get hives or rarely more serious reactions like trouble breathing and low blood pressure. Be sure to tell the doctor if you have ever had a reaction to any contrast material used for x-rays. You may be asked to drink 1 to 2 pints of a solution of contrast material. This helps outline the intestine so that it is not mistaken for tumors.

Detecting Mesothelioma Using CAT / CT Scan

CT / CAT (computed axial tomography) scans are basically three dimensional x-rays that are able to project extremely detailed internal pictures of the organs, bones and skeletal structures. CT scan is a method of combining images from multiple x-rays using a computer to reproduce cross sectional or three-dimensional pictures of internal organs. It is useful in determining the location and spread of mesothelioma. They are much more accurate in detail than the x-ray, helping the physician / surgeon make a more accurate diagnosis. One of the drawbacks of CT scans is that it cannot differentiate between benign or malignant mesothelioma.

Positron Emission Tomography (PET Scan): In this test, radioactive glucose (sugar) is injected into your vein. Because cancers use sugar much faster than normal tissues, the cancerous tissue takes up the radioactive material. A scanner can spot the radioactive deposits. This test, which is still being
studied, is useful for telling whether a thickening of the tissues is cancer or merely scar tissue. It can also spot spread of the cancer.

Detecting Mesothelioma Using PET Scans

PET imaging is the best and most widely used imaging technology for diagnosing mesothelioma. PET scans use cameras and tracers that form images to indicate biological changes which are able to detect extremely small cancerous tumors. They are much superior in their image quality and details when compared to x-rays, CAT scans, and even MRI scans. PET scans also help the physician / surgeon in determining the staging of the cancer.

Magnetic resonance imaging (MRI): MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. Not only does this produce cross sectional slices of the body like a CT scanner, it can also produce slices that are parallel with the length of your body. A contrast material might be injected just as with CT scans, but is used less often. Sometimes MRI scans are
useful in looking at the diaphragm (the thin muscle at the bottom of the lung cage that is responsible for breathing) where the mesothelioma may spread.

MRI scans are particularly helpful in examining the brain and spinal cord. MRI scans are a little more uncomfortable than CT scans. First, they take
longer - often up to 1 hour. Also, you have to be placed inside a tube, which is confining and can upset people with claustrophobia (fear of enclosed places). The machine also makes a thumping noise that you may find disturbing. Some places will provide headphones with music to block this out.

Detecting Mesothelioma Using MRI Scan

MRI scans are more sophisticated than the x-ray and CT scans. It makes use of high magnetic fields and radio waves, and with the help of a computer give physicians / surgeons a clear picture of the internal organs and skeletal structure. MRI scans are extremely clear and very useful in detecting mesothelioma related soft tissue growths and determining the severity of the tumor.

Source:
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