PET vs Sentinel Lymph Node Biopsy for Staging Melanoma: A Patient Intervention, Comparison, Outcome Analysis

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

“…In the course of initial staging up to stage IIB, the sensitivity of PET and PET/CT for the detection of clinically occult locoregional lymph node metastases is low and clearly inferior to sentinel lymph node scintigraphy with subsequent lymph node dissection [104,105,130,132,[134][135][136][137][138][139]. PET or PET/CT with fluorodeoxyglucose (FDG) should not be performed for the detection and/or localization of locoregional lymph node metastasis.…”

Prospective evaluation of hybrid 18F‐fluorodeoxyglucose positron emission tomography/computed tomography in staging clinically node‐negative patients with penile carcinoma

“…This patient was scheduled for unilateral DSNB (and enrolled into this study) after a recurrence of the penile tumour. 18 F-FDG-PET/CT imaging was done using two different hybrid systems. Until September 2006, a mobile PET/CT system was used (Biograph II, Siemens, Erlangen, Germany); nine patients were examined using this system.…”

“…Patients fasted for ≥ 6 h before an i.v. injection with 300-400 MBq (Biograph II) or 180-240 MBq (GeminiTF) 18 F-FDG. At ≈ 60 min after injection, the PET/CT images were acquired with the patient supine.…”

“…18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been shown to be successful in the staging and treatment monitoring of various malignancies [8,9]. By adding anatomical information from CT to the functional imaging of PET, the recently introduced hybrid PET/CT outperforms single PET in the quality of lymph node staging [10,11].…”

Melanoma Imaging with Highly Specific PET Probes: Ready for Prime Time?

“…The clinical data on PET and PET/CT are based solely on 18 F-FDG imaging, which is expected to change management in 15%-64% of cases when melanoma patients with American Joint Committee on Cancer stage III-IV are evaluated after conventional diagnostic work-up (7). However, the sensitivity of 18 F-FDG PET is not sufficient in the initial diagnosis of metastasis in regional lymph nodes, for which SNB preceded by lymphoscintigraphy is the gold standard (8,9). Given the sometimes small burden of metastatic cells, the insensitivity of a general metabolic agent such as 18 F-FDG is hardly surprising because its tumor-to-background ratio remains below the resolution of the PET detection system in imaging the clinically uninvolved sentinel node basin.…”