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Mesothelioma imaging scans help specialists find malignant tumors and make more accurate diagnoses. Imaging also helps guide biopsies and treatment and track the progress of the disease.
The Importance of Imaging in Mesothelioma Diagnosis
Diagnosing mesothelioma is not straightforward or simple. It requires multiple steps and tools, including medical and asbestos history, physical examination and symptoms, biposies blood tests, and imaging scans.
Imaging is important in diagnosing mesothelioma. It provides information such as the extent of disease in the original organ and show if cancer has spread to other locations. It is not uncommon for a combination of several imaging exams to be performed at initial diagnosis.
Once treatment is underway, your doctors will determine the best imaging studies to evaluate the effectiveness of the plan. Images can help doctors adjust treatments as needed.
This is a common initial study performed when someone has trouble breathing, coughing, or chest discomfort. It is useful in ruling out more common conditions, like pneumonia. An X-ray uses high-energy electromagnetic radiation to image dense tissue in the body.
Using an X-ray image, the doctor can see if the pleura around the lungs has thickened, indicating cancer. X-rays also indicate fluid build-up, another type of asbestos-related condition which may indicate mesothelioma.
X-rays are useful in beginning the diagnostic process, but they are limited. They don’t provide enough detail to give a complete diagnosis or to help stage cancer.
Computed tomography, or CT scans, also uses X-rays. Instead of taking two-dimensional images created with a chest X-ray, this technique takes cross-sectional images of the body. CT imaging is the most commonly used imaging scan for diagnosing and staging mesothelioma.
When undergoing a CT scan, the patient lies on a table while the device moves around the body, making multiple images. A computer then takes those images and creates detailed cross-sections.
A radioactive dye, either injected or ingested as a drink, can provide a more detailed image because the dye helps distinguish between finer structures in the body.
CT scans are useful for diagnosing mesothelioma. Mesothelioma as seen on cross-sectional imaging shows similar features as X-rays but more clearly and with more detail. Radiologists look for:
- Thickening and nodules in the pleura
- A pleural mass
- The spread of cancer to the adjacent pleura
- Invasion of the cancer into the chest wall, diaphragm, or mediastinum
- Pericardial effusion
- Metastasis to lymph nodes or the adjacent lung
- Calcified plural plaques
Doctors can use CT scans to help stage cancer, determining how much it has spread to other tissues. CT scans also help doctors determine if treatment is working and the effect it has had on tumor number and size.
An MRI, or magnetic resonance imaging, creates a picture similar to a CT scan. Instead of X-rays, an MRI uses radio waves to take detailed pictures of the body’s soft tissues. MRI scans typically require a dye to show a contrast between blood vessels and other tissues. If a patient is allergic to the dye used for CT scans, an MRI is an alternative and vice versa.
MRIs are particularly useful for imaging the diaphragm. The diaphragm is often difficult to see in a CT scan because it is located underneath the lungs.
The image produced by an MRI is slightly more detailed than a CT scan. However, an MRI takes significantly longer. To have an MRI, you must lie inside a hollow tube. Because the space is tight, it may not be an option for those who are obese or overweight.
The confined space is also problematic for people who may experience anxiety and fear. Should that be the case, speak with your doctor, and they may be able to prescribe some medication to help alleviate these feelings before the scan.
Positron emission tomography, or PET scans, uses a radioactive material to image the inside of the body. First, a radioactive substance is injected into the body. Next, a scanner takes pictures of the radioactivity.
The process requires you to lie on a table for about half an hour. The image is not as clear as a CT or MRI scan but is useful in other ways.
One important thing a PET scan can determine is whether tissue that appears abnormal is malignant or benign. It can also determine where the cancer has spread because a PET scan produces a whole-body image.
The PET scanner can be combined with a CT scan to give your doctor a more detailed and comprehensive image. This combination also produces a three-dimensional image.
This is a specialized ultrasound to evaluate the function of the heart. This helps determine if there is fluid in the lining around the heart as well as the overall function.
It allows for visualization of the valves as the heart pumps. This is helpful when your doctors want to take a closer look at heart function beyond what is seen on a CT or MRI.
Other Uses for Imaging Scans in Mesothelioma
These imaging techniques are crucial for a complete mesothelioma diagnosis; however, they are useful for much more than that.
If you have mesothelioma, scans can help your doctor stage cancer. The images also allow your doctor to see how far the cancer has spread, as well as how large the tumors are in the original location.
Images also track cancer progression and treatment. If you have surgery, chemotherapy, or radiation, an imaging scan can show how successful that treatment has been. Because they allow your doctor to see the progress of the treatment, these images also influence the next step of cancer treatment.
Completing the Diagnosis After Imaging Scans
An imaging scan is just one of many steps in a complete mesothelioma diagnosis. In the early part of the diagnostic process, your team will use imaging to find areas of abnormal tissue or tumors. They use these images to guide the location of a biopsy.
A biopsy involves removing a small amount of tissue. That sample goes to a pathology lab where a pathologist examines it under a microscope. The pathologist can determine if the cells are malignant, where they originated, and other features that help diagnose the cancer.
Imaging scans are essential to diagnosing, staging, and treating mesothelioma. Talk to your doctor about what scans you need and what to expect.Get Your FREE Mesothelioma Packet
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.