MRI, CT, and sonography in the preoperative evaluation of primary tumor extension in malignant pleural mesothelioma.

Evaluation of the diagnostic value of the imaging modalities computed tomog raphy (CT), magnetic resonance imaging (MRI), and thoracic sonography in th e preoperative staging of malignant pleural mesothelioma. Materials and Met hods: The diagnostic accuracy of CT (n=41), MRI (n=24), and thoracic sonogr aphy (n = 37) were evaluated in 51 patients with histologically proven diff use malignant pleural mesothelioma. Values of sensitivity, specificity, pos itive and negative predictive values, and accuracy were calculated for the assessment of the diaphragm, lung, thoracic wall, pericardial wall, myocard ium, and (retro)peritoneal space. Results: The accuracy rates for CT were 8 5 %, 98 %, 83 %, 73 %, 71 %, and 83 %. MRI had an accuracy of 71 %, 92%, 71 %, 83 %, 71 %, and 96%, the thoracic ultrasound examinations of 76 %, 63 % , 51 %, 60 %, 71 %, and 89%. Conclusions: According to these results CT rem ains the method of choice in the preoperative assessment of T-stage of mali gnant pleural mesothelioma. MRI is of nearly the same value, but is not a m ust. Sonography may be supplementary method for operation planning.