Can integrated 18F-FDG PET/MR replace sentinel lymph node resection in malignant melanoma?

Schaarschmidt, Benedikt Michael; Grueneisen, Johannes; Stebner, Vanessa; Klode, Joachim; Stoffels, Ingo; Umutlu, Lale; Schadendorf, Dirk; Heusch, Philipp; Antoch, Gerald; Pöppel, Thorsten

doi:10.1007/s00259-018-4061-9

Cited by 16 publications

(6 citation statements)

References 41 publications

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“…Similarly, in nearly all the studies included in the subgroup analysis for regional metastasis detection in our meta-analysis, the comparison of [ 18 F]F-FDG PET and SLNB clearly indicated that [ 18 F]F-FDG PET could not serve as a suitable substitute for SLNB. Notably, Schaarschmidt et al [ 87 ] showed that [ 18 F]F-FDG PET/MRI could not also replace SLNB since it did not reliably differentiate benign from malignant lymph nodes. Even with the addition of advanced sequences, including diffusion-weighted imaging (DWI), the sensitivity of [ 18 F]F-FDG PET/MRI was not improved significantly.…”

Section: Discussionmentioning

confidence: 99%

“… Forest plots for the pooled sensitivity and specificity calculation at the lesion level. Horizontal lines represent 95% confidence intervals of the individual studies [ 29 , 30 , 31 , 32 , 34 , 37 , 38 , 45 , 47 , 50 , 51 , 55 , 60 , 61 , 63 , 64 , 68 , 76 , 79 , 80 , 84 , 87 , 92 , 96 , 98 , 102 , 104 , 105 , 106 ]. …”

Section: Figurementioning

confidence: 99%

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Diagnostic Performance of [18F]F-FDG Positron Emission Tomography (PET) in Non-Ophthalmic Malignant Melanoma: A Systematic Review and Meta-Analysis of More Than 10,000 Melanoma Patients

Zamani-Siahkali,

Mirshahvalad,

Pirich

et al. 2024

Cancers

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We described the diagnostic performance of [18F]F-FDG-PET in malignant melanoma by conducting a comprehensive systematic review and meta-analysis of the existing literature. The study was designed following PRISMA-DTA. Original articles with adequate crude data for meta-analytic calculations that evaluated [18F]F-FDG-PET and compared it with a valid reference standard were considered eligible. The pooled measurements were calculated based on the data level (patient/lesion-based). Regarding sub-groups, diagnostic performances were calculated for local, regional and distant involvement. The bivariate model was employed to calculate sensitivity and specificity. The initial search resulted in 6678 studies. Finally, 100 entered the meta-analysis, containing 82 patient-based (10,403 patients) and 32 lesion-based (6188 lesions) datasets. At patient level, overall, [18F]F-FDG-PET had pooled sensitivity and specificity of 81% (95%CI: 73–87%) and 92% (95%CI: 90–94%), respectively. To detect regional lymph node metastasis, the pooled sensitivity and specificity were 56% (95%CI: 40–72%) and 97% (95%CI: 94–99%), respectively. To detect distant metastasis, they were 88% (95%CI: 81–93%) and 94% (95%CI: 91–96%), respectively. At lesion level, [18F]F-FDG-PET had a pooled sensitivity and specificity of 70% (95%CI: 57–80%) and 94% (95%CI: 88–97%), respectively. Thus, [18F]F-FDG-PET is a valuable diagnostic modality for melanoma assessment. It was accurate in various clinical scenarios. However, despite its high specificity, it showed low sensitivity in detecting regional lymph node metastasis and could not replace lymph node biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Diagnostic Performance of [18F]F-FDG Positron Emission Tomography (PET) in Non-Ophthalmic Malignant Melanoma: A Systematic Review and Meta-Analysis of More Than 10,000 Melanoma Patients

Zamani-Siahkali,

Mirshahvalad,

Pirich

et al. 2024

Cancers

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“…(2) loss of a fatty hilus sign; (3) round shape; (4) focally increased cortical thickness; and (5) irregular external contour. 17 At least two suspicious morphological criteria were regarded as signs of malignancy. In addition, long T1 and long T2 signal images, signs of increased signal intensity on DWI images and a low signal on the corresponding ADC map were considered indications of malignancy.…”

Section: Pet/mr Image Analysismentioning

confidence: 99%

Value of 18F-FDG Hybrid PET/MR in Differentiated Thyroid Cancer Patients with Negative 131I Whole-Body Scan and Elevated Thyroglobulin Levels

Chen

Wang

et al. 2021

CMAR

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Purpose: To evaluate the diagnostic performance of 18 F-FDG PET/MR in detecting recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC) who have increased thyroglobulin (Tg) levels but a negative 131 I whole-body scan (WBS). The relationship between 18 F-FDG PET/MR and serum Tg levels was explored. We also evaluated the therapeutic impact of PET/MR on patient clinical management. Patients and Methods: Twenty-nine DTC patients with a negative 131 I-WBS of the last post-therapeutic and increased Tg levels under thyroid-stimulating hormone suppression treatment who underwent 18 F-FDG PET/MR examination were retrospectively analyzed. Results: Of those 29 patients, 18 F-FDG PET/MR findings were true positive, true negative, false positive, and false negative in 18, 7, 2, and 2 patients, respectively. The overall sensitivity, specificity, and accuracy were 90.0%, 77.8%, and 86.2%, respectively. We noticed significant differences in serum Tg levels between the PET/MR-positive and PET/ MR-negative patient groups (P=0.049). Receiver operating characteristic curve analysis showed that a Tg level of 2.4 ng/mL was the optimal cut-off value for predicting PET/MR results. The sensitivity, specificity, and accuracy of PET/MR were higher in patients with Tg levels greater than 2.4 ng/mL than in patients with lower levels. By detecting recurrent or metastatic disease, 18 F-FDG PET/MR altered the clinical management in 7 patients (24.1%) of the overall population. Conclusion: 18 F-FDG PET/MR has high diagnostic accuracy for detecting recurrent or metastatic diseases in DTC patients and is useful for clinical management.

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“…Over the last 20 years, the role of 18 F-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in the evaluation and staging of melanoma has been discussed. [9][10][11] Positron emission tomography/computed tomography (PET/ CT) is a relatively expensive modern tool for oncological staging. Before examination, 18 FDG was injected intravenously.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic value of 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography imaging in acral melanoma–predominant Asian patients

Chen,

Chu,

et al. 2023

Journal of the Chinese Medical Association

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Background: Tumor staging is crucial for melanoma, of which acral melanoma is the predominant subtype in Asians. 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) and 18F-FDG-PET/computed tomography (18F-FDG-PET/CT) serve as non-invasive imaging tools for tumor staging. However, the literature is scarce on the diagnostic value of PET for acral melanoma. Methods: From January 1, 2006, to November 30, 2022, a total of 352 patients were diagnosed with melanoma at our hospital. Of them, 90 were diagnosed with cutaneous melanoma and underwent preoperative PET/CT for staging and sentinel lymph node biopsy or complete lymph node dissection. Staging of PET/CT was confirmed by histopathology or following imaging. The lymph node biopsy, distant metastasis status, and PET/CT imaging results were analyzed. Results: Of all the 90 patients with cutaneous melanoma, 72 of them were diagnosed as acral melanoma(80.0%). Compared with the histopathologic results, the lymph nodes were true-positive, true-negative, false-positive, and false-negative in 12, 54, seven, and 17 cases, respectively. The sensitivity of PET/CT for local lymph nodes was 41.4% (95% confidence interval [CI], 23.5–61.1%), while its specificity was 88.5% (95% CI, 77.8–95.3%). As for the detection of distal metastasis, the PET results were true-positive, true-negative, false-positive, and false-negative in six, 65, 15, and four cases, respectively. The sensitivity of PET for distal metastasis detection was 60.0% (95% CI, 26.2–87.8%), while its specificity was 81.3% (95% CI, 71.0–89.1%). Conclusion: Although non-invasive, PET/CT has relatively low sensitivity in regional lymph node evaluations and fair sensitivity in distal metastasis detection in Asian patients with acral melanoma. Thus, PET/CT may be more useful in patients with clinically palpable nodes or more advanced disease stage.

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Can integrated 18F-FDG PET/MR replace sentinel lymph node resection in malignant melanoma?

Abstract: In conclusion, integrated 18F-FDG PET/MR does not reliably differentiate N-positive from N-negative melanoma patients. Additional DWI does not increase the sensitivity of 18F-FDG PET/MR. Hence, sentinel lymph node biopsy cannot be replaced by 18F-FDG-PE/MR or 18F-FDG-PET/CT.

Cited by 16 publications

References 41 publications

Diagnostic Performance of [18F]F-FDG Positron Emission Tomography (PET) in Non-Ophthalmic Malignant Melanoma: A Systematic Review and Meta-Analysis of More Than 10,000 Melanoma Patients

Diagnostic Performance of [18F]F-FDG Positron Emission Tomography (PET) in Non-Ophthalmic Malignant Melanoma: A Systematic Review and Meta-Analysis of More Than 10,000 Melanoma Patients

Value of 18F-FDG Hybrid PET/MR in Differentiated Thyroid Cancer Patients with Negative 131I Whole-Body Scan and Elevated Thyroglobulin Levels

Diagnostic value of 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography imaging in acral melanoma–predominant Asian patients

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