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The use of FDG‐PET/CT to detect early recurrence after resection of high‐risk stage III melanoma
Author(s) -
Stahlie Emma H. A.,
Hiel Bernies,
Stokkel Marcel P. M.,
Schrage Yvonne M.,
Houdt Winan J.,
Wouters Michel W.,
Akkooi Alexander C. J.
Publication year - 2020
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.26155
Subject(s) - medicine , asymptomatic , cohort , positron emission tomography , stage (stratigraphy) , radiology , pet ct , melanoma , adjuvant therapy , nuclear medicine , fluorodeoxyglucose , cancer , surgery , paleontology , cancer research , biology
Abstract Background The role of surveillance imaging in high‐risk stage III melanoma patients after complete surgical resection remains controversial, and with the advent of adjuvant therapy, it may also be expanded. Therefore, we evaluated two fluorine‐18 fluorodeoxyglucose‐positron emission tomography/computed tomography (FDG‐PET/CT) protocols in two cohorts. Methods Cohort 1 (n = 35) focused on surveillance in asymptomatic patients (before approval and reimbursement of adjuvant therapy) and was assigned to 5x FDG‐PET/CT's after surgery: one every 6 months for 2 years, with one final scan after 3 years. Cohort 2 (n = 42) was assigned to one screening FDG‐PET/CT, which took place in between surgery and the start of adjuvant treatment. Results In cohort 1 (median follow‐up: 33 months), 12 patients (34.3%) developed recurrence detected by FDG‐PET/CT, of which 7 (20.0%) were detected with the first scan. Sensitivity and specificity were 92.3% and 100%, respectively. In cohort 2, recurrence was suspected on nine scans (21.4%) and four (9.5%) were true positive. The number of scans needed to find one asymptomatic recurrence were 8.8 and 10.5 in cohort 1 and 2, respectively. Conclusions FDG‐PET/CT is a valuable imaging tool to detect recurrence in stage III melanoma, even shortly after surgery. A surveillance FDG‐PET/CT protocol after surgery or a screening PET/CT before adjuvant therapy should be considered.