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Primary staging and follow‐up of high risk melanoma patients with whole‐body 18 F‐fluorodeoxyglucose positron emission tomography
Author(s) -
Rinne Daniela,
Baum Richard P.,
Hör Gustav,
Kaufmann Roland
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980501)82:9<1664::aid-cncr11>3.0.co;2-2
Subject(s) - medicine , melanoma , positron emission tomography , nuclear medicine , lymph node , radiology , fluorodeoxyglucose , lung cancer , prospective cohort study , cancer research
BACKGROUND Positron emission tomography (PET) has been retrospectively reported to be a sensitive method for detecting malignant melanoma metastases. METHODS One hundred consecutive patients with high risk melanoma (tumor thickness >1.5 mm) were prospectively evaluated (52 at primary diagnosis, comprising Group A, and 48 during follow‐up, comprising Group B) by whole‐body PET and conventional diagnostics (CD). RESULTS In Group A, the sensitivity of PET was 100% and the specificity was 94%, whereas CD did not identify any of the 9 lymph node metastases and demonstrated a lower specificity (80%). In Group B, 121 lesions were detected, 111 by PET and 69 by conventional imaging. On the basis of patients, the sensitivity, specificity, and accuracy of PET were 100%, 95.5%, and 97.9%, respectively (91.8%, 94.4%, and 92.1%, respectively, on the basis of single metastases). Prospectively, CD did not identify all patients with progression (sensitivity, 84.6%) and detected significantly fewer metastases (sensitivity, 57.5%) with much lower specificity (68.2% on the basis of patients, 45% on the basis of single lesions); therefore, the accuracy of CD was 77.1% on the basis of patients and only 55.7% on the basis of single metastases. Results also depended on specific sites: while PET yielded a higher sensitivity in detecting cervical metastases (100% vs. 66.6%) and abdominal metastases (100% vs. 26.6%), computed tomography proved to be superior in detecting small lung metastases (87% vs. 69.6%). CONCLUSIONS PET is a highly sensitive and specific technique for melanoma staging. With the exception of the brain, one single whole‐body 18 F‐fluorodeoxyglucose‐PET scan could replace the standard battery of imaging tests currently performed on high risk melanoma patients. Cancer 1998;82:1664‐71. © 1998 American Cancer Society.