1. High SUVmax on FDG-PET indicates pleomorphic subtype in epithelioid malignant pleural mesothelioma: supportive evidence to reclassify pleomorphic as nonepithelioid histology.
- Author
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Kadota K, Kachala SS, Nitadori J, Suzuki K, Dunphy MP, Sima CS, Travis WD, Rusch VW, and Adusumilli PS
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinosarcoma classification, Carcinosarcoma mortality, Carcinosarcoma pathology, Female, Follow-Up Studies, Humans, Male, Mesothelioma classification, Mesothelioma mortality, Mesothelioma pathology, Middle Aged, Neoplasm Staging, Neoplasms, Glandular and Epithelial classification, Neoplasms, Glandular and Epithelial mortality, Neoplasms, Glandular and Epithelial pathology, Pleural Neoplasms classification, Pleural Neoplasms mortality, Pleural Neoplasms pathology, Prognosis, Radionuclide Imaging, Retrospective Studies, Survival Rate, Carcinosarcoma diagnostic imaging, Mesothelioma diagnostic imaging, Neoplasms, Glandular and Epithelial diagnostic imaging, Pleural Neoplasms diagnostic imaging
- Abstract
Background: We have recently proposed to reclassify the pleomorphic subtype of epithelioid malignant pleural mesothelioma (MPM) as nonepithelioid (biphasic/sarcomatoid) histology because of its similarly poor prognosis. We sought to investigate whether preoperative maximum standardized uptake value (SUVmax) on F-fluorodeoxyglucose (FDG) positron emission tomography (PET) correlates with histologic subtype in MPM., Methods: Clinical data were collected for 78 patients with MPM who underwent preoperative FDG-PET. We retrospectively classified the epithelioid tumors into five subtypes: trabecular, tubulopapillary, micropapillary, solid, and pleomorphic. Tumors were categorized by SUVmax into two groups: low (<10.0) and high (≥10.0)., Results: The median overall survival of epithelioid tumors with high SUVmax (n = 12) was significantly shorter (7.1 months) than that of epithelioid tumors with low SUVmax (n = 54, 18.9 months, p < 0.001) and comparable to nonepithelioid tumors (n = 12, 7.2 months). Epithelioid tumors with pleomorphic subtype (n = 9) had marginally higher SUVmax (mean ± SD: 10.6 ± 5.9) than epithelioid nonpleomorphic subtype (n = 57, 6.5 ± 3.2, p = 0.050), and were comparable to that of nonepithelioid tumors (n = 12, 9.1 ± 4.8). Among the epithelioid tumors with high SUVmax (n = 12), 50% (n = 6) showed pleomorphic subtype. In contrast, among epithelioid tumors with low SUVmax (n = 54), 6% (n = 3) showed epithelioid pleomorphic subtypes (p = 0.001). A positive correlation between mitotic count and SUVmax was observed (r = 0.30, p = 0.010)., Conclusions: Pleomorphic subtype of epithelioid MPM showed higher SUVmax than the epithelioid nonpleomorphic subtype and was similar to nonepithelioid histology. Preoperative SUVmax on FDG-PET in epithelioid MPM can indicate patients with pleomorphic subtype with poor prognosis, supporting their reclassification as nonepithelioid.
- Published
- 2012
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