Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Micrometastases of Primary Cutaneous Malignant Melanoma

Abstract

This study demonstrates the limitations of FDG-PET scanning in staging patients with primary melanoma. SNB is the only reliable method for identifying micrometastatic disease in the regional draining node.

A Prospective Analysis of Positron Emission Tomography and Conventional Imaging for Detection of Stage IV Metastatic Melanoma in Patients Undergoing Metastasectomy

“…FP findings were most often due to FDG-PET uptake in surgical wounds, inflammatory sites, and benign tumors. [6][7][8][9][10][11][12][13][14][15][16][17][18] Several recent reports have suggested that FDG-PET may be superior to CI for the identification of metastases; some have suggested that FDG-PET may be able to replace CI as a screening modality for these patients. 13,14,20 In a prospective study of 100 patients with AJCC stage I to III melanoma, Rinne et al 13 directly compared the sensitivity and specificity FDG-PET with those of CI.…”

Optimal follow-up for melanoma

“…A few radiologists are in favor of staging regional lymph node basins in stage I-II melanoma with high-resolution ultrasonography [24][25][26]. However, the general opinion is that targeted high-resolution ultrasonography is not an effective substitute for SLNB in patients with primary melanoma [27][28][29][30]. Several authors investigated the use of chest x-rays in staging and concluded that its use is questionable, because of low detection rates, high false-positive percentages and subsequent high patient anxiety [31][32][33].…”

“…This raises the question of the importance of this relatively new technique in staging any melanoma patient. In several studies, FDG-PET has shown limited sensitivity to detect microscopic lymph node metastases in this selected group of patients with stage I and II melanoma [27][28][29][92][93][94]. Mijnhout et al documented in a systematic review and meta-ana lysis of the literature from the 1990s, a pooled sensitivity of 79% and a specificity of 86% for the detection of melanoma metastases (both lymph nodes and distant) [93].…”

Comparison between 18F-FDG PET (PET/CT) and sentinel lymph node biopsy in the detection of regional lymph node metastasis of various malignancies: review of the literature

“…In a prospective study of 50 patients with primary melanomas (thickness > 1 mm or lymphatic invasion), Acland et al [29] compared the sensitivity of 18 F-FDG PET with SLNB for the detection of micrometastatic malignant melanoma. All of the patients underwent 18 F-FDG PET and subsequent SLNB.…”