Patient history including possible asbestos exposure calls for further testing. Biopsy is needed to confirm diagnosis, but imaging tools such as X-rays, CT or MRI scans may be utilized for preliminary assessment of tumor size, location, and extent. These methods are of limited use for detecting small, early-stage tumors, and give no indication of malignancy, but may be of additional use in gauging the effects of treatment. Biopsy options include thorascopy, which may be used to remove a fluid or tissue sample from inside the chest, and peritoneoscopy, to access abdominal tissues. Once mesothelioma is confirmed by biopsy, staging, dependent on the size and spread of the tumor, is important for determining therapeutic options. Evaluation of pulmonary function is necessary to determine candidacy for aggressive surgical procedures.