Imaging and Mesothelioma Diagnosis
Getting a diagnosis for mesothelioma is scary, but it is important. Anyone who has this type of cancer can only benefit from getting a speedy and accurate diagnosis. Too often these diagnoses come too late or the diagnosis is incorrect and treatment for the cancer is delayed. Mesothelioma is a difficult cancer to treat and time is of the essence so that treatment can begin.
One of the most important tools doctors have in making the diagnosis of mesothelioma is imaging. There are several ways in which the cancerous tissues can be imaged, but these techniques are also used to rule out cancer as a diagnosis. The most commonly used imaging techniques in diagnosing mesothelioma are X-rays, CT scans, MRIs, and PET scans.
The Importance of Imaging
Imaging is so important in diagnosing mesothelioma because it is a safe way of actually seeing what is inside the body. Blood tests are imperfect and exploratory surgery is risky. Getting an image of an area of the body can give doctors a clearer idea of whether or not cancerous tissues are present. Furthermore, these images also help doctors determine where to do a biopsy. Without those images, biopsies are blind and not as useful in making a diagnosis.
When a patient describes symptoms like those characteristic of mesothelioma, like coughing, pain, and trouble breathing, a chest X-ray is typically the first imaging scan a doctor will order. An X-ray uses high energy electromagnetic radiation to image dense tissue in the body. A doctor can see if the pleura around the lungs have thickened, which may indicate cancer, or if there is fluid buildup. Fluid may be indicative of mesothelioma, another type of asbestos-related condition, or pneumonia.
CT scans also use X-rays. CT stands for computed tomography and this imaging technique takes cross-sectional images of the body, as opposed to just one two-dimensional image as with a chest X-ray. To get a CT scan you must lie on a table while the device moves around your body making multiple images. The computer attached to the device takes those images and creates detailed cross sections. A radioactive dye, either injected or ingested as a drink, can provide an image that is even more detailed. The dye helps distinguish between finer structures in the body.
CT scans are used for diagnosing mesothelioma. The image can show your doctor where abnormal tissue is, which could be malignant tumors. These scans are also used to stage cancer be determining how much it has spread to other tissues. CT scans also help doctors determine if treatment is working and if tumors have shrunk or been eliminated.
An MRI, or magnetic resonance imaging, scan creates a similar picture to a CT scan. It takes detailed pictures of the soft tissues in the body, but instead of X-rays, uses radio waves to do so. MRI scans also typically require a dye to show contrast, but it is injected, never ingested. 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, which is underneath the lungs and difficult to see in a CT scan.
The image produced by an MRI is slightly more detailed than that of a CT scan, but it takes much longer to make. To have an MRI you must lie inside a hollow tube. The space is tight and for people who are overweight or obese, this may not even be an option. The confined space is problematic for some people because it causes fear and anxiety.
Positron emission tomography, or PET scans uses a radioactive material to image the inside of the body. A radioactive substance is injected into the body and a scanner takes pictures of the radioactivity. The process takes about a half an hour while you lie on a table. The image is not as clear as a CT or MRI scan, but it is useful in other ways.
One important thing a PET scan can tell a doctor is if abnormal looking tissue, like thickened tissue, is malignant or benign. This scan can also determine where cancer has spread because it 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 an image that is three-dimensional.
These imaging techniques are useful for diagnosing and staging pleural and peritoneal mesothelioma, but not for pericardial mesothelioma, the cancer of the lining of the heart. Instead, doctors usually choose to do an echocardiogram when this type of mesothelioma is suspected. An echocardiogram uses sound waves to image the heart and can determine if there is fluid in the lining around the heart. To get this image you will lie down as a technician moves a wand over the skin on your chest. It is quick and painless.
Imaging Goes Beyond Diagnosis
These imaging techniques are crucial as part of a complete diagnosis for mesothelioma, but they are useful for much more than that. If you have mesothelioma, scans can help your doctor stage the cancer. The images allow your doctor to see how far the cancer has spread and how large the tumors are in the original location.
Images are also used to track the progression of cancer and its treatment. If you have surgery, chemotherapy, or radiation to treat your cancer, an imaging scan can show how successful that treatment has been. It can also inform the next step in treatment and help your doctor see if the cancer is progressing and getting worse.
Imaging is an important diagnostic, staging, and tracking technique. Your doctor will choose the type of image that is best for your situation or will use a combination of images to get the best results. As technologies continue to develop, doctors are likely to have even more and better options for using imaging for mesothelioma.
Page edited by Dave Foster
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