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      Multimodality imaging for characterization, classification, and staging of malignant pleural mesothelioma.

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          Abstract

          Malignant pleural mesothelioma (MPM) is the most common primary malignancy of the pleura and is associated with asbestos exposure in approximately 80% of patients. The patient prognosis is poor, with a median survival of 9-17 months after diagnosis. However, improved survival and decreased morbidity and mortality have been demonstrated when the diagnosis is made in the early stages of disease and specific treatment strategies are implemented. A staging system that focuses on the extent of primary tumor (T), lymph node involvement (N), and metastatic disease (M) has been devised by the International Mesothelioma Interest Group and emphasizes factors related to overall survival. Radiologists should recognize the manifestations of MPM across multiple imaging modalities, translate these findings into the updated staging system, and understand the effects of appropriate staging on treatment and survival. Computed tomography (CT) remains the primary imaging modality used to evaluate MPM and efficiently demonstrates the extent of primary tumor, intrathoracic lymphadenopathy, and extrathoracic spread. However, additional imaging modalities, such as magnetic resonance (MR) imaging of the thorax and positron emission tomography (PET)/CT with fluorodeoxyglucose, have emerged in recent years and are complementary to CT for disease staging and evaluation of patients with MPM. Thoracic MR imaging is particularly useful for identifying invasion of the chest wall, mediastinum, and diaphragm, and PET/CT can accurately demonstrate intrathoracic and extrathoracic lymphadenopathy and metastatic disease.

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          Author and article information

          Journal
          Radiographics
          Radiographics : a review publication of the Radiological Society of North America, Inc
          Radiological Society of North America (RSNA)
          1527-1323
          0271-5333
          Oct 2014
          : 34
          : 6
          Affiliations
          [1 ] From the Departments of Radiology, Baylor University Medical Center, Dallas, Tex (L.T.N.); Department of Radiology, David Grant Medical Center, Travis Air Force Base, Fairfield, Calif (J.P.L.); Department of Radiology, Mount Auburn Hospital, Cambridge, Mass (L.K.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (G.F.A.); and Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (B.W.C.).
          Article
          10.1148/rg.346130089
          25310424
          0f2f0930-955a-463a-a261-10c04399092c
          History

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