Mesothelioma Diagnosis

When mesothelioma is suspected, physicians will order a battery of tests. These tests are used to confirm or reject a mesothelioma diagnosis.

For the first step, doctors use a general physical and full medical history to review the potential for mesothelioma. This includes an occupational history because most cases of mesothelioma come from workplace exposure. During the physical, doctors will look for obvious signs and symptoms of the disease, such as chest congestion, abdominal swelling or heart palpitations. Because these symptoms are easily misinterpreted as other diseases, it is vital to consult with a doctor who is skilled in diagnosing mesothelioma.

Imaging Scans

There are several varieties of imaging scans available to physicians. For a mesothelioma diagnosis, some doctors may choose to use just one, while other run a series of imaging tests using a variety of methods. Each comes with a set of risks and complications:

• X-ray - X-ray machines use a form of electromagnetic radiation and have been used for decades. X-rays are often used to diagnose mesothelioma and other less dangerous diseases including bronchitis. They allow physicians to see soft-tissue and bone areas that are filled with fluids and unusual masses. If an X-ray detects anything abnormal, doctors usually move to more advanced imaging tests. The radiation that X-ray machines emit is known to be cancerous so precautions are taken when using the machine.
• CT Scan - Also known as a CAT or a Computer Tomography scan, this is often used to locate tumors and defining the progress of the disease. The machine creates three-dimensional images to allow for a clear view of the injured areas. CT scans are typically used when diagnosing pleural mesothelioma and peritoneal mesothelioma because of their accuracy. Even though CT scans are widely used, the images produced are not as clear as an MRI.
• MRI - A magnetic resonance imaging (MRI) test is frequently used to get a clear view of internal body structures. The machine uses magnets and radio waves to get a clear picture. The images are so clear that doctors frequently use MRIs to view cancerous cells prior to biopsies or resections. For many patients, an MRI is not comfortable and causes a feeling of claustrophobia. During typical MRIs, patients must lay still on a table that slides into a tunnel-shaped area. Newer models of the machine, called Open MRIs, help alleviate this stress.
• PET Scans - This imaging test, called positron emission tomography, utilizes radioactive molecules to produce an image. Patients ingest or are injected with a tracer that contains radioactive elements. The machine is then able to trace the flow of the liquid through the body to determine problems. A PET scan shows essential information about injured tissue. PET scans are used to stage the mesothelioma and to help make the decision about treatment options.

Once a series of diagnostic tests is complete, many doctors will order biopsies to confirm a diagnosis.

Biopsy Tests

Biopsies are a vital step to any mesothelioma diagnoses because they allow doctors to view real tissue instead of computer-generated images. There are three main types:

• Fine Needle Aspiration - Also known as an FNA, this uses a thin needle to extract cells from a tumor or lesion.
• Needle Biopsy - A thicker needle, often guided by ultrasound, is used to remove cells and tissue for further examination.
• Surgical Biopsy - Doctors remove tissue and cell samples through a surgical incision.

Once the series of tests is completed, many physicians are able to determine the type and stage of the mesothelioma.