Document Detail


Utility of preoperative 18F-FDG PET/CT and brain MRI in melanoma patients with palpable lymph node metastases.
MedLine Citation:
PMID:  20422454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aims of this prospective study were to determine the diagnostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and brain MRI in melanoma patients with palpable lymph node metastases and to assess the impact of these imaging modalities on their management.
MATERIALS AND METHODS: Between October 2006 and March 2009, PET/CT and brain MRI were performed in 70 melanoma patients with palpable nodal lymph node metastases and without evidence of systemic dissemination after physical examination. Hypermetabolic PET/CT lesions were examined by histology or cytology or were imaged further and followed if no pathology confirmation could be obtained.
RESULTS: PET/CT findings changed the intended regional node dissection in 26 patients (37%). PET/CT was false negative in 4 patients (6%) and false positive in 1 (1%). This resulted in a sensitivity of 87%, specificity of 98%, accuracy of 93%, positive predictive value of 96%, and negative predictive value of 91%. MRI revealed brain metastases in 5 patients (7%). The overall survival of patients without additional lesions on PET/CT was 84% after 2 years, which was better than the 56% in patients with additional metastases (P < .001).
CONCLUSIONS: PET/CT has an 87% sensitivity and 98% specificity in the detection of other metastases in melanoma patients with palpable lymph node involvement. PET/CT leads to a change in the planned regional node dissection in 37% of the patients in this study. MRI revealed brain metastases in 5 patients (7%). PET/CT findings correlate with survival.
Authors:
Tjeerd S Aukema; Renato A Valdés Olmos; Michel W J M Wouters; W Martin C Klop; Bin B R Kroon; Wouter V Vogel; Omgo E Nieweg
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Publication Detail:
Type:  Journal Article     Date:  2010-04-27
Journal Detail:
Title:  Annals of surgical oncology     Volume:  17     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-20     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2773-8     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. t.aukema@nki.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain Neoplasms / diagnosis*,  surgery
Female
Fluorodeoxyglucose F18 / diagnostic use*
Follow-Up Studies
Humans
Lymph Nodes / pathology,  radiography,  radionuclide imaging
Lymphatic Metastasis
Magnetic Resonance Imaging / utilization*
Male
Melanoma / diagnosis*,  surgery
Middle Aged
Positron-Emission Tomography / utilization*
Preoperative Care
Prospective Studies
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Survival Rate
Tomography, X-Ray Computed / utilization*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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