Utility of Preoperative [(18)]F Fluorodeoxyglucose–Positron Emission Tomography Scanning in High-Risk Melanoma Patients

Brady, Mary S.; Akhurst, Timothy; Spanknebel, Kathryn; Hilton, Susan; Gönen, Mithat; Patel, Ami B.; Larson, Steven M.

doi:10.1245/aso.2006.02.008

Cited by 81 publications

(51 citation statements)

References 14 publications

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“…Positron emission tomography (PET)-CT fusion studies and brain MR are the preferred imaging modalities to detect clinically occult distant metastasis. In a prospective trial of 103 patients with stage IIC, III, or IV melanomas, Brady et al [3] performed whole-body CT and PET scans and evaluated their impact on surgical decision making. Results were correlated with pathologic or clinical follow-up within 4 months to confirm the accuracy of the radiographic findings.…”

Section: Preoperative Imagingmentioning

confidence: 99%

Multidisciplinary management of special melanoma situations: Oligometastatic disease and bulky nodal sites

Sarnaik

Zager²,

Sondak

2007

Curr Oncol Rep

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Potentially resectable, advanced stage melanoma in the form of extensive palpable adenopathy or limited systemic metastases presents a significant challenge but also offers the prospect of long-term disease control. Although surgical resection is the mainstay of therapy, involvement of a multidisciplinary team is required for optimal management of these special situations. These patients need to be evaluated preoperatively by the team, discussed at a multidisciplinary conference, and treated by experienced physicians with access to the full spectrum of modern surgical and oncologic therapy. Surgical resection is generally extensive and may require en bloc resection of important anatomic structures. Adjuvant radiation or systemic therapy is required in many patients to help achieve durable regional and systemic control of disease. In addition, novel therapies, such as neoadjuvant chemotherapy, targeted therapies, or investigational intralesional therapies, may ultimately play a role in the management of these difficult clinical situations and require further evaluation, as preliminary studies show some encouraging results.

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Section: Preoperative Imagingmentioning

confidence: 99%

Multidisciplinary management of special melanoma situations: Oligometastatic disease and bulky nodal sites

Sarnaik

Zager²,

Sondak

2007

Curr Oncol Rep

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“…16,17 However, PET scans may not be as useful in initial staging because of limitations in detection of small tumor deposits and lymph node micrometastases. [4][5][6]18,19 Recently, the development of dualmodality PET/CT scans has added to the options available to physicians for radiologic staging.…”

mentioning

confidence: 99%

Role of radiologic imaging at the time of initial diagnosis of stage T1b‐T3b melanoma

Yancovitz

Finelt

Warycha

et al. 2007

Cancer

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BACKGROUND. In patients with T1b‐T3b cutaneous melanoma the utility of radiologic imaging at the time of diagnosis is unclear. Whether initial imaging led to a change in stage or treatment plan was investigated. METHODS. The melanoma database was searched for patients with T1b‐T3b primary lesions, clinically N0, and asymptomatic for metastatic disease. Radiologic studies conducted before wide local excision ± sentinel lymph node biopsy as well as all further imaging and investigations were analyzed. Outcome measures included upstaging, change in initial surgical management, true‐positive, false‐positive, true‐negative, and false‐negative rates of each imaging modality. RESULTS. In all, 344 preoperative imaging studies (chest x‐ray [CXR], computed tomography [CT], positron emission tomography [PET]/CT) were performed on 158 patients, resulting in 49 findings suspicious for metastatic melanoma and 134 findings suggestive of nonmelanoma pathology. Only 1 of 344 (0.3%) studies, a PET/CT, correlated with confirmed metastatic melanoma. The false‐positive rates were CXR 5 of 7 (71.4%), chest CT 21 of 24 (87.5%), abdomen/pelvis CT 10 of 11 (90.9%), head CT 2 of 2 (100.0%), PET/CT 3 of 5 (60.0%). No patient was upstaged or had a change in initial surgical management based on preoperative imaging. The cost of all initial imaging and imaging to follow‐up abnormal findings was estimated as $555,308 for the 158 patients studied. CONCLUSIONS. Imaging at the time of initial diagnosis of T1b‐T3b, clinically N0, M0 melanoma was of low yield with a high false‐positive rate, and did not lead to upstaging or change in initial surgical management. These findings suggest that imaging of asymptomatic patients at the time of diagnosis may not be warranted. Cancer 2007. © 2007 American Cancer Society.

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“…It is widely accepted that, for patients with early localized melanoma, PET is not sensitive in detecting the metastatic lesions and thus can not satisfactorily benefit the patients (40)(41)(42). PET/ CT is more useful in stage III patients because it can help to identify lesions that can not be diagnosed by CT and display locations that can not be displayed by conventional CT (e.g., limbs) (43). In a systematic review that included 17 studies, PET had a sensitivity of 68−87% and a specificity of 92−98% in sage III/IV patients.…”

Section: Medical Imagingmentioning

confidence: 99%

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

et al. 2016

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Utility of Preoperative [(18)]F Fluorodeoxyglucose–Positron Emission Tomography Scanning in High-Risk Melanoma Patients

Abstract: PET scanning facilitates the appropriate management of high-risk melanoma patients being considered for operative intervention. PET imaging in addition to CT scanning should be strongly considered before operation in patients at high risk for occult metastatic disease.

Cited by 81 publications

References 14 publications

Multidisciplinary management of special melanoma situations: Oligometastatic disease and bulky nodal sites

Multidisciplinary management of special melanoma situations: Oligometastatic disease and bulky nodal sites

Role of radiologic imaging at the time of initial diagnosis of stage T1b‐T3b melanoma

Chinese Guidelines on the Diagnosis and Treatment of Melanoma (2015 Edition)

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