Mesothelioma is notoriously difficult to spot for physicians, which is why imaging scans are so vital for getting an accurate diagnosis. Even if the doctor diagnoses you with cancer, he still may mistake mesothelioma for other types of cancer because mesothelioma resembles many cancers even at the cellular level.
There are several types of imaging scans that are used to diagnose mesothelioma, including a CT scan. Below is more information about this important imaging tool.
CT Scan Overview
A CT scan offers a great deal of detail of your chest because it makes a 3D image of your body. This allows doctors to see behind any fluid buildups that may block vital visual signs of asbestos cancer, such as pleural thickening or tumors.
The imaging process begins when you lie on a table over which the device is attached. As you pass through the scanner, the machine rotates around you. Every rotation creates a new X-ray scan, also known as a slice, of your chest and abdominal area. The X-ray images are put into a computer that takes all the images and makes a 3D image of your chest.
Some CT scans may use various contrast materials to help the device tell the difference between organs and body structures. This material is able to differentiate between small mesothelioma tumors and body organs better. Doctors often inject this contrast material into your vein. Or, he may have you drink it a few hours before the procedure.
Some of the other radiological findings that a CT scan can see are: (Itnonline.com)
- Extent of tumor growth along the pleural surface and into the chest wall, mediastinum, or diaphragm.
- How much tumors have invaded the chest wall or diaphragm
- Whether there has been pleural thickening and effusion, and extent
- Nodular pleural thickening, pleural thickening that is more than one centimeter, and concentric pleural thickening
- Calcified pleural plaques
CT scans are more effective than X-rays because they show how far mesothelioma has spread in the chest or abdomen. Having this type of visual data is vital because it helps the doctor to determine the stage of your mesothelioma, which affects the treatment plan. (mesothelioma metastasis radiology)
CT scans are usually used for pleural mesothelioma and peritoneal mesothelioma, but not for the pericardial type of the disease. It is generally considered too risky to use CT-level radiation over the heart.
Still, many doctors say the CT scan is the best for the chest and abdomen, which are where mesothelioma forms. CT scans can help physicians to determine the stage of your tumor. This scan also can show if it has spread to lymph nodes or other organs.
A new technique called CT perfusion can show if cancer cells are spreading in the bloodstream.
Other Radiology Imaging Scans to Detect Mesothelioma
X-rays are usually the first type of imaging used to investigate signs of mesothelioma and other diseases that affect the lungs or heart. Those who are at higher risk of developed asbestos cancer, such as factory, shipbuilding, or construction workers, may get a chest X-ray as an initial screening tool. But even under the best circumstances, an X-ray only offers limited information.
The radiographic findings on an X-ray are nonspecific and can look like other diseases such as metastatic carcinoma, lymphoma, and benign asbestos disease. Further, small, malignant pleural effusions may not be seen on an X-ray. Also, a large pleural effusion (fluid buildup) can hide pleural thickening and tumors. Still, an X-ray is a good initial tool to screen for mesothelioma because it can see pleural effusions, which are a common sign of asbestos cancer.
Some of the other radiological findings that a chest X-ray can see are:
- Unilateral pleural thickening or effusion
- Plaque-like or nodular pleural thickening
- Loss of hemithoracic volume
- Encased lung, which can lead to compression of lung tissue, the elevation of the diaphragm, and mediastinal shift toward tumors
An MRI may be used after an X-ray and CT scan for some patients. It offers more delineation of soft tissues and allows the coronal and sagittal planes to be imaged. An MRI also can better see metastasis of mesothelioma; a CT scan often cannot see metastasis. MRI scans also can be appropriate for patients who cannot handle the dyes used in CT scans. Note that as good as an MRI scan is, it still does not allow for a definite diagnosis of mesothelioma; only a tissue biopsy can provide a definitive diagnosis.
Some of the other radiological findings that an MRI can see are:
- Chest wall invasion with tumors, endothoracic fascial involvement, invasion of the diaphragm with tumors
- Iso-intense T1 signals of muscles of the chest wall
- Increased signals on T2-weighted images
The bottom line is that imaging scans, including CT scans, are helpful to diagnose mesothelioma. But only a tissue biopsy can definitively diagnose mesothelioma. And even with a biopsy, it can get tricky; mesothelioma resembles other cancers at the microscopic level. So it is wise to seek immediate medical attention from an experienced mesothelioma doctor if you think you could have mesothelioma based on your work history and symptoms.
A positron emission tomography (PET) scan is useful to determine the prognosis of a patient with pleural mesothelioma. PET scans use a radioactive sugar that is put into the patient’s blood. Because mesothelioma cells grow quickly, they absorb more sugar than other cells. A special type of camera is used to create an image of radioactive areas in the body.
A PET scan picture can give the physician a better idea if the thickening of the pleura seen on a CT scan is cancer or scar tissue. This test also can be used to see if mesothelioma has spread in the lymph nodes and other parts of the body. Lastly, this scan is helpful if your physician thinks the cancer has spread in the body but is uncertain where.
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