The role of FDG-PET-CT is limited in initial staging of nodal metastasis for thin cutaneous melanoma

Cheng, Daniel; McNicoll, Christopher F.; Kirgan, Daniel; Jones, Maris S.; Rivera, Mariangela; Doyle, Gabriela M.; Guzman, Margaret D. De; Baynosa, Jennifer; Hill, Charles R. St.

doi:10.1016/j.amjsurg.2020.03.031

Cited by 3 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As mentioned above, a larger study population is needed to determine the validity parameters, also on an organ-based level in this context of primary staging. Because the detection of very early lymphatic metastasis, which can sometimes only be detected by immunohistochemistry, is insufficient, the sensitivity of 18 F-FDG-PET/CT in thinner melanoma is limited [11,19,22,24]. Accordingly, the overall high sensitivity in this study is favored by the preselection of patients with higher risk by the physicians indicating initial whole-body imaging.…”

Section: Discussionmentioning

confidence: 93%

“…For 18 F-FDG-PET imaging, the proportion of correctly detected lymphatic metastasis drops dramatically from 83-100% to only 23% when the size of the lymphatic metastasis is smaller or equal to 5 mm [22]. Because the different levels of likelihood of obtaining a positive finding depend on the tumor thickness [23] and the limited sensitivity in initial nodal metastasis detection [24], whole-body 3D imaging for initial staging is only recommended for patients with a higher tumor thickness, namely primary-stage pT4b tumors [6]. Still, it has not yet been comprehensively applied for primary staging in melanoma patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Whole-Body Imaging for the Primary Staging of Melanomas—A Single-Center Retrospective Study

Mayer,

Gaa,

Wasserer

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: Melanoma staging at diagnosis predominantly depends on the tumor thickness. Sentinel lymph node biopsy (SLNB) is a common tool for primary staging. However, for tumors of >4 mm with ulceration, 3D whole-body imaging and, in particular, Fluor-18-Deoxyglucose positron emission tomography combined with computed tomography (18F-FDG-PET/CT), is recommended beforehand. This study aimed to investigate the real-world data of whole-body imaging for initial melanoma staging and its impact on the subsequent diagnostic and therapeutic procedures. Methods: In this retrospective single-center study, 94 patients receiving 18F-FDG-PET/CT and six patients with whole-body computed tomography (CT) scans were included. The clinical characteristics, imaging results, and histologic parameters of the primary tumors and metastases were analyzed. Results: Besides the patients with primary tumors characterized as pT4b (63%), the patients with pT4a tumors and pT3 tumors close to 4 mm in tumor thickness also received initial whole-body imaging. In 42.6% of the patients undergoing 18F-FDG-PET/CT, the imaging results led to a change in the diagnostic or therapeutic procedure following on from this. In 29% of cases, sentinel lymph node biopsy was no longer necessary. The sensitivity and specificity of 18F-FDG-PET/CT were 66.0% and 93.0%, respectively. Conclusion: Whole-body imaging as a primary diagnostic tool is highly valuable and influences the subsequent diagnostic and therapeutic procedures in a considerable number of patients with a relatively high tumor thickness. It can help avoid the costs and invasiveness of redundant SLNB and simultaneously hasten the staging of patients at the time of diagnosis.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Whole-Body Imaging for the Primary Staging of Melanomas—A Single-Center Retrospective Study

Mayer,

Gaa,

Wasserer

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…FDG-PET/CT is considered an effective tool for staging and treatment response assessment in metastatic melanoma patients [ 8 ]. However, a low specificity for initial locoregional lymph node metastases in early stages was observed [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Malignancy Rate of Indeterminate Findings on FDG-PET/CT in Cutaneous Melanoma Patients

et al. 2021

View full text Add to dashboard Cite

Background: The use of 18F-2-Fluor-2-desoxy-D-glucose Positron Emission Tomography/Computed Tomography FDG-PET/CT in clinical routine for staging, treatment response monitoring and post treatment surveillance in metastatic melanoma patients has noticeably increased due to significant improvement of the overall survival rate in melanoma patients. However, determining the dignity of the findings with increased metabolic activity on FDG-PET/CT can be sometimes challenging and may need further investigation. Purpose: We aimed to investigate the malignancy rate of indeterminate findings on FDG-PET/CT in metastatic cutaneous melanoma patients. Methods: This single-center retrospective study included cutaneous melanoma patients who underwent FDG-PET/CT in clinical routine between 2015 and 2017 with findings reported as indeterminate and therefore requiring further evaluation. The dignity of the included findings was determined by subsequent imaging and, if required, additional histopathology. The impact of the outcome on the clinical management was also reported. Results: A total of 842 FDG-PET/CT reports of 244 metastatic cutaneous melanoma patients were reviewed. Sixty indeterminate findings were included. Almost half of all indeterminate findings were lymph nodes, lung nodules and cerebral lesions. In total, 43.3% of all included findings proved to be malignant. 81% of all malignant lesions were metastases of cutaneous melanoma, while 19% of all malignant lesions could be attributed to other primary malignancies, such as lung, breast, thyroid and colorectal cancers. Malignant findings influenced clinical management in 60% of the cases. Conclusion: Indeterminate findings on FDG-PET/CT in metastatic cutaneous melanoma patients should be further investigated. Almost one out of every two indeterminate findings on FDG-PET/CT is malignant. The majority of the findings are melanoma manifestations, however, in a significant percentage, other primary tumors are found. Upon verification, patient management is changed in most cases.

show abstract

PET Imaging of Melanoma

Alipour

Iravani

Hicks

2022

Nuclear Medicine and Molecular Imaging

View full text Add to dashboard Cite

The role of FDG-PET-CT is limited in initial staging of nodal metastasis for thin cutaneous melanoma

Cited by 3 publications

References 22 publications

Whole-Body Imaging for the Primary Staging of Melanomas—A Single-Center Retrospective Study

Whole-Body Imaging for the Primary Staging of Melanomas—A Single-Center Retrospective Study

Malignancy Rate of Indeterminate Findings on FDG-PET/CT in Cutaneous Melanoma Patients

PET Imaging of Melanoma

Contact Info

Product

Resources

About