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The role of preoperative positron emission tomography/computed tomography (PET/CT) in patients with high‐risk melanoma
Author(s) -
Barsky Maya,
Cherkassky Leonid,
Vezeridis Michael,
Miner Thomas J.
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23549
Subject(s) - medicine , asymptomatic , positron emission tomography , radiology , melanoma , sentinel lymph node , biopsy , nuclear medicine , cancer , surgery , breast cancer , cancer research
Background Positron emission tomography/computed tomography (PET/CT) scanning is commonly used for the preoperative staging of patients with at least intermediate thickness (>1 mm) melanomas. Its role in staging at initial diagnosis for clinically asymptomatic patients is not yet established. Methods We examined records of all patients receiving an operation for at least an intermediate thickness melanoma from June 2005 to June 2011. Results of preoperative PET/CT scans were evaluated in asymptomatic patients with a negative physical exam. Outcome measures included changes in clinical management, as well as incidence of true‐ and false‐positives. Results PET/CT scans were performed for 149 patients with at least an intermediate thickness melanoma. Positive scans were identified in 28% (41/149) of patients. An invasive procedure to further aid in diagnosis was performed in 44% (18), yet only 6 (15%) patients were diagnosed with metastatic cancer (85% false positive rate). Each of these patients had regional disease subsequently diagnosed by a sentinel lymph node biopsy. No distant metastatic disease was identified. Conclusions Preoperative PET/CT in asymptomatic patients is of limited benefit in staging asymptomatic melanoma patients with at least an intermediate thickness melanoma and may lead to unnecessary invasive procedures. J. Surg. Oncol 2014; 109:726–729 . © 2013 Wiley Periodicals, Inc.