Targeted High-Resolution Ultrasound Is Not an Effective Substitute for Sentinel Lymph Node Biopsy in Patients With Primary Cutaneous Melanoma

Abstract

US is not an appropriate substitute for SLN biopsy, but it is of value in preoperative SLN assessment and postoperative monitoring.

Improved Detection of Regional Melanoma Metastasis Using 18F-6-Fluoro-N-[2-(Diethylamino)Ethyl] Pyridine-3-Carboxamide, a Melanin-Specific PET Probe, by Perilesional Administration

“…As suggested by various clinical and preclinical studies (14,19), we used architectural criteria on ultrasound images together with changes in nodal volume to predict the presence of metastases in PLNs. Although PLN status was successfully predicted by these methods in 47 of the 49 mice studied, 1 PLN was judged as false-negative and 1 as false-positive by ultrasound.…”

“…At 5 d after tumor implantation, ultrasound scans revealed that 10 of the 49 mice had an increased left PLN volume, in many cases associated with irregular, crenulated edges suggestive of nodal metastasis (14,19). Typical day 5 ultrasound images for negative and positive PLNs are shown in Figure 1A.…”

“…Thus, 18 F-FDG PET cannot substitute for lymphoscintigraphy and SLNB in melanoma patients (9,12,13). In addition, all of the current imaging modalities for regional staging still require biopsy or excision of the node for histologic confirmation of metastasis (3,14), which can delay definitive management planning and increase the costs of the diagnostic process.…”

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].…”

Initial results of imaging melanoma metastasis in resected human lymph nodes using photoacoustic computed tomography

“…In the case of a positive SLN a radical lymphadenectomy could be performed directly without scheduling a second surgery at a later date. Methods such as high resolution ultrasound imaging 6 and frozen section histopathological examination 7 have been evaluated as intraoperative techniques to lead to one-step surgery. However, these methods have not achieved the required sensitivities, with false negative rates up to 10%.…”