The diagnostic accuracy of 18F-FDG PET in cutaneous malignant melanoma

Krug, Bruno; Pirson, Anne-Sophie; Crott, Ralph

doi:10.1007/s00259-010-1475-4

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…It currently represents the state of the art in PET-based imaging. High-quality studies have shown that the diagnostic significance of PET and PET/CT in melanoma differs depending on tumor stage [104,132,133].…”

Section: S Reskementioning

confidence: 99%

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

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

180

148

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Section: S Reskementioning

confidence: 99%

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

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

180

148

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“…These results were consistent with other published data. In a recent metaanalysis based on 2,905 patients, Krug et al (13,14) reported 18 F-FDG PET to have a sensitivity and specificity of 83% and 85%, respectively, at initial staging. In a prospective study of 253 stage III patients, Bastiaannet et al (15) found 18 F-FDG PET to have a sensitivity and specificity of 0.86 and 0.93, respectively.…”

Section: Discussionmentioning

confidence: 99%

¹²³I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial

et al. 2013

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Our group has developed a new radiopharmaceutical, 123 I-N-(2-diethylaminoethyl)-2-iodobenzamide ( 123 I-BZA2), a benzamide derivative able to bind to melanin pigment in melanoma cells. In a prospective and multicentric phase III clinical study, the value of 18 F-FDG PET/CT and 123 I-BZA2 scintigraphy was compared for melanoma staging. Methods: Patients with a past history of cutaneous or ocular melanoma were included from 8 hospitals. 18 F-FDG imaging was performed according to a standard PET protocol. Whole-body, static planar, and SPECT/CT (if available) images were acquired 4 h after injection of a 2 MBq/kg dose of 123 I-BZA2. 18 F-FDG and 123 I-BZA2 sensitivity and specificity for the diagnosis of melanoma metastasis were calculated and compared on both a lesion basis and a patient basis. True-positive and true-negative lesion status was determined after 6 mo of clinical follow-up or according to lesion biopsies (if available). Melanin content in biopsies was evaluated with the standard Fontana-Masson silver method and was correlated with 123 I-BZA2 uptake. Based on statistical analysis, the number of inclusions was estimated at 186. Results: In all, 87 patients were enrolled from 2008 to 2010. Of these, 45 (52%) had metastases. A total of 338 imaging abnormalities were analyzed; 86 lesions were considered metastases, and 20 of 25 lesion biopsies found melanoma metastases. In a patient-based analysis, the sensitivity of 18 F-FDG for diagnosis of melanoma metastases was higher than that of 123 I-BZA2, at 87% and 39%, respectively (P , 0.05). For specificity, 18 F-FDG and 123 I-BZA2 were not statistically different, at 78% and 94%, respectively. In a lesion-based analysis, the sensitivity of 18 F-FDG was statistically higher than that of 123 I-BZA2 (80% vs. 23%, P , 0.05). The specificity of 18 F-FDG was lower than that of 123 I-BZA2 (54% vs. 86%, P , 0.05). According to biopsy analysis, only 9 of 20 metastatic lesions (45%) were pigmented with high melanin content. 123 I-BZA2 imaging was positive for 6 of 8 melanin-positive lesions, fairly positive for 3 of 10 melanin-negative lesions, and negative for 7 of 10 melaninnegative lesions. The sensitivity and specificity of 123 I-BZA2 for the diagnosis of melanin-positive lesions were 75% and 70%, respectively. Because of a low 123 I-BZA2 sensitivity, this clinical trial was prematurely closed after 87 patients had been included. Conclusion: This study confirms the value of 18 F-FDG PET/CT for melanoma staging and strengthens the high accuracy of 123 I-BZA2 for diagnosis of melanin-positive metastatic melanoma. Moreover, benzamide derivatives radiolabeled with therapeutic radionuclide may offer a new strategy for the treatment of metastatic melanoma patients harboring melanin-positive metastases. Mel anoma accounts for nearly 80% of all deaths related to cutaneous cancer (1). It is the second most common cancer among patients in their second decade (2). For localized lesions with a tumor thickness of less than 1.5 mm (stage I or II), melanoma can be cured by tota...

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“…Die mit dem CT fusionierten PET-Bilder ermöglichen den morphologischen Läsionsnachweis der PET-Herdbefunde. Qualitativ hochwertige Studien haben gezeigt, dass beim malignen Melanom der diagnostische Stellenwert der PET und PET/CT stadienabhängig differenziert betrachtet werden muss [132,133]. Zahlreiche weitere Melanom-affine Radiopharmaka sind derzeit meist in der vorklinischen Evaluation und werden hier nicht behandelt [131].…”

Section: S Reskeunclassified

“…Im Rahmen des Primärstagings bis einschließlich Stadium IIB ist die Sensitivität der PET und PET/CT zum Nachweis der klinisch okkulten lokoregionalen Lymphknotenmetastasierung niedrig und der Wächterlymphknoten-Szintigraphie mit nachfolgender Lymphknotendissektion und der Sonographie deutlich unterlegen [104,105,130,[132][133][134][135][136][137][138][139]. PET oder PET/CT mit Fluordesoxyglukose (FDG) sollten nicht zum Nachweis und/oder der Lokalisation der lokoregionalen Lymphknotenmetastasierung durchgeführt werden.…”

Section: S Reskeunclassified

Malignes Melanom S3‐Leitlinie “Diagnostik, Therapie und Nachsorge des Melanoms”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

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This first German evidence-based guideline for cutaneous melanoma was developed under the auspices of the German Dermatological Society (DDG) and the Dermatologic Cooperative Oncology Group (DeCOG) and funded by the German Guideline Program in Oncology. The recommendations are based on a systematic literature search, and on the consensus of 32 medical societies, working groups and patient representatives. This guideline contains recommendations concerning diagnosis, therapy and follow-up of melanoma. The diagnosis of primary melanoma based on clinical features and dermoscopic criteria. It is confirmed by histopathologic examination after complete excision with a small margin. For the staging of melanoma, the AJCC classification of 2009 is used. The definitive excision margins are 0.5 cm for in situ melanomas, 1 cm for melanomas with up to 2 mm tumor thickness and 2 cm for thicker melanomas, they are reached in a secondary excision. From 1 mm tumor thickness, sentinel lymph node biopsy is recommended. For stages II and III, adjuvant therapy with interferon-alpha should be considered after careful analysis of the benefits and possible risks. In the stage of locoregional metastasis surgical treatment with complete lymphadenectomy is the treatment of choice. In the presence of distant metastasis mutational screening should be performed for BRAF mutation, and eventually for CKIT and NRAS mutations. In the presence of mutations in case of inoperable metastases targeted therapies should be applied. Furthermore, in addition to standard chemotherapies, new immunotherapies such as the CTLA-4 antibody ipilimumab are available. Regular follow-up examinations are recommended for a period of 10 years, with an intensified schedule for the first three years.

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The diagnostic accuracy of 18F-FDG PET in cutaneous malignant melanoma

Cited by 7 publications

References 17 publications

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

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

¹²³I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial

Malignes Melanom S3‐Leitlinie “Diagnostik, Therapie und Nachsorge des Melanoms”

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The diagnostic accuracy of 18F-FDG PET in cutaneous malignant melanoma

Cited by 7 publications

References 17 publications

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

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

123I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial

Malignes Melanom S3‐Leitlinie “Diagnostik, Therapie und Nachsorge des Melanoms”

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¹²³I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial