What tests are performed to help diagnose mesothelioma? Question 11

As we mentioned previously, the first test that is usually performed after the history and physical exam is an x-ray of the chest. These x-rays can show areas of fluid accumulation, scarring of the lungs, masses in the chest, and other types of abnormal findings, but they are not as sensitive as other tests available today. 

The results of the chest x-ray will usually prompt the doctor to order a CAT or CT scan (computerized axial tomography scan) of the chest and abdomen. These scans provide a three-dimensional view of the area of the body that the physician is interested in. CT scans have a better ability to show how much solid mass is present and how much fluid contributes to the picture. 

They also give a much better anatomic picture so your doctor can see how any masses relate to the lung, heart, diaphragm (the muscle that helps you breathe), and blood vessels in the chest or abdomen. 

CT scans do not tell the doctor what type of tumor it is or whether the disease has invaded other structures, but they do give a very good idea of whether your disease can be classified as early with minimal disease (Stage I), later with moderate amount of disease (Stage II), or advanced with a large amount of disease (Stages III and IV). (We will discuss the concept of staging in more detail later on.) 
In mesothelioma, a CT scan is not very good for showing whether your lymph nodes (the round structures in certain positions in the chest and abdomen that drain the lung and intestines and act as filters and sites for immune responses) are involved. 

The reason it does not show this well is that the pleura can be thickened in areas where the lymph nodes are, and this lumpy, bumpy thickening can be confused with lymph nodes or can hide lymph nodes.

The doctor may also request an MRI (magnetic resonance image). An MRI uses radio waves and strong magnets along with a computer to form detailed images of the body. 

The MRI can occasionally give the doctor information about whether the diaphragm or chest wall have become involved and if the tumor has invaded through it. Not all mesothelioma specialists use MRIs in their workup 

A PET scan (positron emission tomography scan) is a relatively new type of scan that shows how the body takes up and uses glucose (sugar). 

Tumors, cancer cells, and areas that are inflamed or infected use glucose at a higher rate than normal tissues do. Since a radioactive tracer is attached to the glucose injected into your body, the areas which use glucose at a higher rate (i.e. tumors) will hold onto the radioactive tracer longer than normal cells. 

Areas on PET scans that “light up” as bright spots are abnormal. It is important to know, however, that abnormal areas on PET scans are not necessarily cancerous; they can also be the result of inflammation. 

The PET scan can also give the doctor information as to whether the cancer has spread outside the original area to other parts of the body, and it may pick up areas of spread that are completely unexpected. 

There have not been enough large studies that prove the usefulness of this scan in mesothelioma, and therefore it has not been approved by most insurance companies as a standard test for mesothelioma, as it has been for lung cancer. 

However, there are mechanisms that can help pay for PET scans that doctors who do them (nuclear medicine physicians) can help you with. Ask them about these programs.


Your doctor will also order a biopsy when a tumor or fluid is suspected to be cancerous.




CAT scan A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography, computed tomography (CT scan), or computerized tomography. 
Magnetic resonance imaging(mag-NET-ik REZo-nans IM-a-jing)(MRIA procedure in which  radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as CT or x-ray. MRI is especially useful for imaging the brain, spine, the soft tissue of joints, and the inside of bones. Also called nuclear magnetic resonance imaging.
PET scan Positron emission tomography scan. A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. 

 


What tests are performed to help diagnose mesothelioma? Question 11 What tests are performed to help diagnose mesothelioma? Question 11 Reviewed by Ari on 1:06 AM Rating: 5

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