Mesothelioma Diagnosis


Properly diagnosing mesothelioma can be a challenge. If you have mesothelioma symptoms, your doctor will order tests and procedures to confirm your diagnosis. While diagnostic techniques are getting better, you may find that healthcare professionals unfamiliar with the disease will have a tough time diagnosing and staging your condition. If you suspect you have mesothelioma, reach out to a mesothelioma specialist for further guidance.

Steps in Diagnosing Your Mesothelioma

Mesothelioma is diagnosed through numerous tests, and your doctor will determine the best diagnostic procedure for your specific circumstance.

The five most common types of mesothelioma tests are:

  • Medical and environmental history
  • Imaging
  • Blood
  • Fluid and tissue biopsy
  • Pulmonary function

Overview of Mesothelioma Diagnostic Techniques

Medical and Environmental History

If you worked in certain industries, such as mining or construction, you’re at a significantly higher risk of having mesothelioma. It’s important to inform your doctor of your work history involving asbestos.

The first step in diagnosing any form of cancer is performing a medical history and full physical exam. Your doctor will review your complete health and also ask questions about your medical history and life experience.

Because mesothelioma is almost always caused by direct exposure to asbestos or asbestos-like substances, your doctor may also ask about your environmental history.

Imaging Tests

Once doctors suspect mesothelioma, imaging tests are typically the first form of investigation. Imaging tests may include:

  • Chest x-rays
  • CT scans
  • MRI scans
  • PET scans
  • Echocardiograms

How these tests work and what they search for vary, but they all use some form of imagery to get a closer look at your body.

Blood Tests

Mesothelioma Justice Network Brief

Mesothelioma increases the levels of osteopontins—soluble mesothelin-related peptides (SMRP) and other substances found in the blood. These substances can be detected in the blood by a laboratory, and your doctor may order blood tests as part of your mesothelioma diagnosis.


Currently, blood tests alone are not able to diagnose mesothelioma, although scientific research is underway to help improve the efficacy of these tests. If your blood tests suggest you may have mesothelioma, additional tests will be administered to confirm the diagnosis.

Fluid or Tissue Biopsies

The best—and only conclusive—way to diagnose mesothelioma is by performing a biopsy of tissue or fluid cells.

In this procedure, your oncologist or mesothelioma specialist will use a small needle to remove suspected cancer cells or fluids from your body and then investigate them under a microscope.

Pulmonary Function Tests

If you receive a pleural mesothelioma diagnosis, your doctor may request pulmonary function tests to determine how well your lungs are currently functioning. This information can be crucial when considering surgical options that may remove part or all of your lung.

Types of Mesothelioma Imaging Tests

There are five types of imaging tests that may be used to confirm your mesothelioma diagnosis. These tests are:

  1. Chest x-rays
  2. CT scans
  3. MRI scans
  4. PET scans
  5. Echocardiograms

Chest X-Rays

A chest x-ray is the first imaging test your doctor is likely to administer if he or she suspects you have mesothelioma. X-rays use light rays to create a picture of the inside of your body.

Chest x-rays can reveal:

  • Calcium deposits in the lungs
  • Thickening of the lung lining
  • Fluid build-up in the lungs
  • Other lung abnormalities that may indicate mesothelioma

Computer Tomography (CT) Scans

Similar to x-rays, a computed tomography (CT) scan is used to create a comprehensive image of your body that can locate mesothelioma and other forms of cancer. Before you can receive a CT scan, you’ll be asked to drink an oral contrast solution. You may also receive an IV contrast to help outline your organs on the scans.

The CT will take numerous images, creating a cross-sectional view of your body and many of the components inside of it. CTs are one of the most reliable forms of confirming a cancer diagnosis.

Positron Emission Tomography (PET) Scans / PET-CT Scans

Positron emission tomography (PET) is a type of imaging scan that uses a sugary radioactive substance to detect cancer cells. If you receive a PET, a low dose of a radioactive substance will be injected into your body and you will wait for approximately 1 hour before receiving a PET scan.

Cancer cells grow at a rapid pace, which causes them to consume a larger quantity of sugar than other cells. The PET scan uses the injected radioactive material to observe the contrast in this sugar consumption and see whether cells are cancerous, ultimately revealing where cancer has spread within your body.

Some facilities have machines that are capable of performing a CT scan and a PET scan at the same time. Because the 2 types of scans perform slightly different functions, a PET-CT scan can help your doctor diagnose and stage mesothelioma with greater accuracy.

Magnetic Resonance Imaging (MRI) Scans

A magnetic resonance imaging (MRI) scan is similar to a CT scan in many ways but uses radio waves instead of light waves to take a detailed look at your body. An IV contrast solution is given before an MRI, which allows medical professionals to view the contrast between your organs and issues.

MRI scans are excellent at displaying soft tissue imagery and can be highly effective in diagnosing mesothelioma.

However, the procedure usually isn’t used until mesothelioma or cancer is already suspected, because of the time and physical restraints. If you receive an MRI, you can expect to lay inside a tube for up to an hour while the MRI scan occurs.


Echocardiograms are a type of imaging test for the heart, which utilizes sound waves to take an image. As a specialized form of ultrasound, an echocardiogram uses gel placed on the chest and a wand to send the sound waves into the body and create a picture on a monitor.

Your doctor may request an echocardiogram if he or she suspects fluid build up around your heart, or to see how well your heart is functioning.

Types of Mesothelioma Blood Tests

Blood tests are an incredibly cost-efficient and minimally invasive way to test for mesothelioma, which is why many cancer researchers are working on methods for improving blood tests as a diagnostic tool.

Researchers are looking into new biomarkers and other genetic factors as mesothelioma diagnostic tools. It’s likely that blood tests will become a stronger diagnostic tool in the future.

For now, your doctor may use the following types of blood tests:

  • SMRP test
  • N-ERC test
  • Osteopontin test
  • MPF test


The most common mesothelioma blood test is the SMRP test, also referred to as the trademarked-name MesoMark®. This test looks for soluble mesothelin-related peptides (SMRP)—a biomarker that occurs in the blood when mesothelioma cells are present.

N-ERC Test

Similar to the SMRP test, the N-ERC test can identify a type of mesothelin called N-ERC using an enzyme. The N-ERC test is considered more accurate than the SMRP test for identifying cancer but isn’t as reliable for diagnosing mesothelioma specifically because the enzyme is formed by many types of cancer.

Osteopontin Test

Osteopontin is a naturally occurring protein that increases when a person has mesothelioma. Your doctor may test for this biomarker if you have been exposed to asbestos in the past. The osteopontin test can determine whether you have cancer but does not indicate what form. Therefore, osteopontin tests that come back positive will require additional testing to confirm your diagnosis.

MPF Test

The MPF test is used to detect megakaryocyte potentiation factor (MPF), which is a protein often found in mesothelioma patients. While it’s not entirely clear how MPF works, scientists have noted very high levels of MPF in mesothelioma patients. The MPF test is a newer innovation that’s already being used while scientists continue to research and improve it.

Types of Fluid and Tissue Biopsies for Mesothelioma

Fluid and tissue tests are often used to confirm a mesothelioma diagnosis, by reviewing microscopic cells under a microscope.

Over the past decade, mesothelioma specialists have been developing tissue banks with mesothelioma samples, allowing medical professionals to compare and diagnose cancer tumors and cells with greater accuracy.

These tests are called biopsies and may be performed using one of several techniques:


If your doctor suspects you have mesothelioma, a thoracoscopic biopsy may be performed. This is often the preferred type of mesothelioma biopsy because of its accuracy. With a thoracoscopy, doctors create a small incision in the chest and use video-assisted thoracoscopic surgery (VATS) to perform the biopsy via tiny tools that are guided by a camera.

Fine Needle Aspiration

If a thoracoscopy isn’t possible, a fine needle aspiration may be used to collect the cell samples. This procedure utilizes a long, skinny needle to collect sample cells, and is valued for its ability to access hard-to-reach locations within the body, including the lungs and heart.

Additional Types of Biopsy

Although thoracoscopy and fine needle aspiration are the 2 most common types of mesothelioma biopsy, other techniques may be used if your suspected cancer is hard to reach, the required surgical tools are unavailable or if there are other reasons the typical biopsies can’t be performed.

All biopsies follow the same general process: tissues or fluids are collected, sent to a laboratory and then reviewed under a microscope.

Common Diagnostic Methods by Mesothelioma Location

Because each mesothelioma location is essentially its own unique disease, doctors require specific tools and techniques to diagnose mesothelioma is different areas of the body.

Here are the common tests and tools used for each mesothelioma location:

Pleural Mesothelioma Diagnostic Tests

  • Chest X-Rays
  • CT
  • MRI
  • Fluid biopsy (thoracentesis)
  • Tissue biopsy

Peritoneal Mesothelioma Diagnostic Tests

  • Chest X-Rays
  • CT
  • MRI
  • Fluid biopsy (thoracentesis)
  • Tissue biopsy

Pericardial Mesothelioma Diagnostic Tests

  • Echocardiogram
  • MRI
  • Fluid biopsy (pericardiocentesis)
  • Tissue biopsy

Diagnosing Mesothelioma In The Future

Mesothelioma specialists recognize that you’re more likely to have a positive outcome if your mesothelioma is diagnosed early. For that reason, researchers across the nation are working on new techniques for both earlier and more accurate diagnosis.

Many of these future diagnostic techniques are focused on biomarkers, which uses substances or processes to identify abnormalities in the body. A very basic example is a fever, where an increase in body temperature is a biomarker for illness.

Biomarkers for cancer patients are complex, often using specific genes, cell growth patterns, proteins or other molecular substances to indicate the presence of mesothelioma.

If you’ve been diagnosed with mesothelioma, contact us today regarding the next steps to take. Mesothelioma patients have legal rights that may make you eligible to receive legal compensation to cover your treatment costs and other damages. Contact our Justice Support Team today to learn more.

View Author and Sources
  1. American Cancer Society. “How Is Malignant Mesothelioma Diagnosed?” Retrieved from Accessed on January 1, 2018.
  2. US National Library of Medicine. “Primary Pericardial Mesothelioma Unique Case and Literature Review.” Retrieved from Accessed on January 1, 2018.

Last modified: August 2, 2018