Document Detail


Interpretation, accuracy and management implications of FDG PET/CT in cutaneous malignant melanoma.
MedLine Citation:
PMID:  17325590     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the accuracy of different interpretative approaches and to evaluate the management implications of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in cutaneous malignant melanoma. METHODS: We retrospectively identified 60 consecutive patients who underwent 76 PET/CT scans for cutaneous malignant melanoma. PET/CT reports were classified as positive, negative, or equivocal for regional and distant disease. Scan indication (staging, restaging, surveillance, or therapeutic monitoring), tumour stage, presence or absence of regional or distant disease, and post-scan management changes were determined by review of all available medical records. Maximum standardized uptake values (SUV(max)) of all findings were noted. Diagnostic accuracy of PET/CT was compared using either a high or low threshold interpretation (i.e. subtle, but indeterminate findings coded negative or positive, respectively). The frequency of management changes was compared between patient subgroups (stratified by tumour stage or indication). RESULTS: Using a high threshold interpretative approach, the overall accuracy of PET/CT for disease was 72.4% (55/76), which was significantly (P<0.05) greater than the accuracy of 53.9% (41/76) seen when using a low threshold approach. Per scan accuracy by staging site was 92.1% (70/76) for regional and 76.3% (58/76) for distant disease. PET/CT changed management in 21 of 76 studies (27.6%). When stratified by stage and indication, management changes occurred in all patient subgroups, except for stage I patients (0 of 5). CONCLUSION: When interpreted with a high threshold approach, PET/CT demonstrates high accuracy for the diagnosis of both regional and distant disease in cutaneous malignant melanoma and frequently changes management in patients with stage II-IV disease referred for a variety of indications.
Authors:
Matthew S Falk; Anne K Truitt; Fergus V Coakley; Mohammed Kashani-Sabet; Randall A Hawkins; Benjamin Franc
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  28     ISSN:  0143-3636     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-02-27     Completed Date:  2007-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  England    
Other Details:
Languages:  eng     Pagination:  273-80     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Male
Melanoma / diagnosis*,  therapy*
Middle Aged
Positron-Emission Tomography / methods*
Prognosis
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Skin Neoplasms / diagnosis*,  therapy*
Tomography, X-Ray Computed / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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