The role of FDG-PET/CT in preoperative staging of sentinel lymph node biopsy-positive melanoma patients

Frary, Evan C.; Gad, Dorte; Bastholt, Lars; Hess, Søren

doi:10.1186/s13550-016-0228-1

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…This is in harmony with the previous findings of Malik et al [12], who showed during studying 54 patients that the clinical risk factors for malignancy are related to age and the mean age of their studied patients was 51.3 + 16.4 years. Previously, Frary et al [13] showed during studying of 46 cases of MM that males were more common than females (26 males "56.53%" and 20 "43.47%" females), similar to our present findings.…”

Section: Discussionsupporting

confidence: 92%

PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma

El-Shourbagy

Mashaly

Khodair

et al. 2020

Egypt J Radiol Nucl Med

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Background: Cutaneous malignant melanoma (CMM) is a highly aggressive tumor with high tendency of return despite complete surgical removal. It has a high risk of dissemination to regional lymph nodes and visceral organs. The prognosis is highly dependent on lymph node involvement and distant metastases. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. The purpose of the present study was to evaluate the role of integrated (PET/CT) in staging, restaging, prognosis, and prediction of recurrence in patients with malignant melanoma. Results: Fifty malignant melanoma patients with age ranged from 28 to74 years (mean age 55.94 + 13.40 years) were 28 males (mean age 56.71 + 12.82) and 22 females (mean age 54.95 + 14.34). All our patients were histopathologically proven to have malignant melanoma. Twenty-one patients came for initial staging by 18F-FDG PET/CT. Their findings were compared with the reference standards and showed the sensitivity of 93.33%, specificity of 60%, and accuracy of 85.71% for primary staging. 18F-FDG PET/CT scan in 11 clinical suspicion patients of relapse after treatment showed the sensitivity of 100%, specificity of 66.66%, positive predictive value of 88.88%; negative predictive value of 100%; and accuracy of 90.90%. FDG-PET/CT of whole body scan in 18 cases of stage IV melanoma showed sensitivity of 100%, specificity of 66.66%, and overall accuracy of 94.44% for detection of distant metastases. SUVmean and SUVmax in all studied groups were significantly higher in true positive more than true negative or false-positive patients diagnosed by PET/CT with high sensitivity (82.88-100%). Conclusion: PET/CT imaging enhanced diagnostic performance in detection of the primary malignancy, in followup of high-risk patients and patients with suspected or known local or distant recurrence, and in restaging of patients with known distant metastatic disease to assess tumor response.

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Section: Discussionsupporting

confidence: 92%

PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma

El-Shourbagy

Mashaly

Khodair

et al. 2020

Egypt J Radiol Nucl Med

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“…Lymph node dissection should be done to treat patients who become stage 3 if the result is positive. In stage 4 patients, there is no need for lymph node dissection because there is already distant metastasis . Studies have shown that PET/CT is superior to other conventional imaging modalities such as ultrasonography, whole‐body MRI, CT alone, or PET alone.…”

Section: Discussionmentioning

confidence: 99%

“…Whole‐body PET imaging with FDG can be used to detect metastases in melanoma metastases due to the relatively high uptake of FDG . However, the role of FDG‐PET/CT in MM staging has not been fully determined …”

Section: Introductionmentioning

confidence: 99%

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Efficacy of positron emission tomography and computed tomography in clinical staging of cutaneous malignant melanoma

Yılmaz

Orhan

Şahin

et al. 2020

Dermatologic Therapy

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Accurate staging is very important for determining the prognosis and appropriate treatment for malignant melanoma (MM). The aim of this study is to determine the effectiveness of positron emission tomography and computed tomography (PET/CT) imaging in staging MM. Patients diagnosed with MM who then underwent PET/CT metastasis before treatment were assessed retrospectively. For each patient, the following variables were recorded: Breslow thickness, Clark's level, number of mitoses, the presence of ulceration detected in the pathology report, and the presence of lymph nodes and/or distant metastases detected by PET/CT. The pathology and PET/CT reports of 139 patients (79 female and 60 male) were retrospectively evaluated for staging after MM diagnosis. Patients with a Breslow thickness greater than 3.4 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with regional lymph node metastasis after PET/CT scans. Patients with Breslow thickness greater than 2.85 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with distant metastasis after PET/CT scan. The results of our study suggest that PET/CT imaging for metastasis scanning, starting with T2 patients, may be used in MM staging to reduce the need for sentinel lymph node (SLN) biopsy and lymph node dissection.

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“…All FDG-PET/CT scans were based on the guidelines from the European Association of Nuclear Medicine, [ 23 ] and performed according to the department's standard protocol as previously described [ 24 ] : All examinations were performed on a GE Discovery PET/CT scanner (GE Healthcare, Milwaukee, WI). The CT imaging was performed as a low-dose CT scan without contrast enhancement.…”

Section: Methodsmentioning

confidence: 99%

18F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography can reliably rule-out infection and cancer in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis suspected of disease relapse

et al. 2017

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Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases characterized by systemic inflammation in small- to medium-sized blood vessels. Although immunosuppressive therapy has greatly improved the prognosis for these patients, there are still significant comorbidities, such as cancer and infection, associated with AAV. These comorbidities are often indistinguishable from an underlying AAV disease relapse, and create a clinical conundrum, as these conditions are normally contraindications for immunosuppressive treatment. Thus, it is important to be able to rule out these comorbidities before initiation of immunosuppressive treatment. We examined 18F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography (FDG-PET/CT)'s value in ruling out cancer or infection in patients with AAV.Data were obtained retrospectively for a clinically based cohort of AAV patients who underwent FDG-PET/CT during 2009 to 2014 owing to a suspicion of cancer, infection, or both cancer and infection indistinguishable from disease relapse. FDG-PET/CT conclusions were compared to the final diagnoses after follow-up analysis (mean 43 months).A total of 19 patients were included who underwent a total of 26 scans. The results of FDG-PET/CT outcome compared to final diagnosis were: 9 true positives, 3 false positives, 13 true negatives, and 1 false negative. The diagnostic probabilities for FDG-PET/CT with respect to overall comorbidity (i.e., cancer or infection) were: sensitivity 90% ( 95% confidence interval [CI] 60%–98%), specificity 81% ( 95% CI 57%–93%), positive predictive value 75% (95% CI 47%–91%), negative predictive value 93% (95% CI 68%–99%), and accuracy 84% (95% CI 66%–94%).FDG-PET/CT had a high negative predictive value and ruled out the comorbidities correctly in all but one case of urinary tract infection, a well-known limitation. Our study showed FGD-PET/CT's promise as an effective tool for ruling out cancer or infection in patients with AAV albeit in a limited population.

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The role of FDG-PET/CT in preoperative staging of sentinel lymph node biopsy-positive melanoma patients

Cited by 9 publications

References 29 publications

PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma

PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma

Efficacy of positron emission tomography and computed tomography in clinical staging of cutaneous malignant melanoma

18F-fluoro-deoxy-glucose positron emission tomography combined with computed tomography can reliably rule-out infection and cancer in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis suspected of disease relapse

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