A combination of CT imaging and medical history may soon provide an alternate way to diagnose pleural mesothelioma.

A team of French and Canadian researchers at Laval University in Quebec assessed the use of medical history and imaging features in patients with pleural thickening around the lungs.

The combination of imaging features and a patient’s history of asbestos exposure may provide enough information for an accurate diagnosis.

Diagnosing Pleural Mesothelioma

Pleural mesothelioma is a cancer that affects the lining of the lungs, called the pleura. It’s the most common site of mesothelioma and often challenging to find.

Once a patient begins to show symptoms, doctors typically start the diagnostic process with a physical exam. The doctor collects a thorough medical history – including factors like exposure to asbestos, which is the main cause of mesothelioma.

If an oncologist suspects a patient may have mesothelioma, she may order imaging tests, like X-rays or CT scans, to test for the presence of fluid buildup around the lungs, called a pleural effusion.

If the fluid is present in the chest cavity, the patient will undergo a pleural biopsy, where fluid or tissue is extracted and tested by a pathologist for malignant cells.

Biopsies also determine what type of mesothelioma cells are present: epithelioid, sarcomatoid, or a combination, called biphasic. Determining the cell type helps oncologists determine treatment options.

Typically, a biopsy is the standard test for accurately diagnosing pleural mesothelioma. However, some patients are not fit for undergoing biopsy procedures.

The Study

The study objective was to determine if the utility of medical history and imaging features is an effective way to diagnose pleural mesothelioma.

Researchers analyzed 92 Malignant Pleural Effusion (MPE) patients. Doctors reviewed imaging scans and medical charts of each patient and compared imaging features in those with primary MPE vs. secondary MPE.

Primary MPE subjects had mesothelioma, while secondary MPE subjects had other forms of cancer, like breast cancer or lung cancer.

The researchers evaluated the diagnostic value of medical history and imaging features in MPE subjects, and found pleural mesothelioma patients shared several common characteristics: they are male, exposed to asbestos, and experienced mediastinal, diaphragmatic, and circumferential pleural thickening.

Exposure to asbestos and circumferential pleural thickening showed a significant association with a pleural mesothelioma diagnosis.

Researchers concluded the combination of circumferential pleural thickening and a history of asbestos exposure may be sufficient to make a clinical MPM diagnosis.

Future Pleural Mesothelioma Diagnosis

Pleural biopsy is still the most reliable way to diagnose pleural mesothelioma. CT scans and asbestos history may be enough for patients who aren’t able to have a biopsy. Researchers are optimistic about using this alternative for future patients.


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