FDG PET/CT for Staging and Restaging Malignant Mesothelioma

Semin Nucl Med. 2022 Nov;52(6):806-815. doi: 10.1053/j.semnuclmed.2022.07.005. Epub 2022 Aug 11.


Malignant mesothelioma is an aggressive tumor originating from the mesothelial cells and presenting in general with a very poor prognosis. The pleural localization represents the prevailing disease site, while peritoneal involvement is commonly rare. The WHO classifies mesotheliomas into epithelioid, biphasic, and sarcomatoid histotypes, having diverse outcome with the sarcomatoid or biphasic forms showing the poorest prognosis. Given the peculiar rind-like pattern of growth, mesothelioma assessment is rather challenging for medical imagers. Conventional imaging is principally based on contrast-enhanced CT, while the role of functional and metabolic imaging is regarded as complementary. By focusing essentially on the staging and restaging role of [18F]FDG PET/CT in malignant mesotheliomas, the present review will summarize the available data present in literature and provide some hints on alternative imaging and future perspectives. Given the prevailing incidence of pleural disease, the majority of the information will be addressed on malignant pleural mesothelioma, although a summary of principal characteristics and imaging findings in patients with peritoneal mesothelioma will be also provided.

Publication types

  • Review

MeSH terms

  • Fluorodeoxyglucose F18
  • Humans
  • Mesothelioma* / diagnostic imaging
  • Mesothelioma* / metabolism
  • Mesothelioma* / pathology
  • Mesothelioma, Malignant* / diagnostic imaging
  • Pleural Neoplasms* / diagnostic imaging
  • Pleural Neoplasms* / metabolism
  • Pleural Neoplasms* / pathology
  • Positron Emission Tomography Computed Tomography


  • Fluorodeoxyglucose F18