The significance of imaging examinations during follow-up for malignant melanoma.

Currently, there is a general lack of consensus regarding optimal strategy and imaging during follow-up for patients suffering from melanoma. Our aim was to analyse the utility of various imaging procedures, in particular CT scans, during the follow-up of patients with different stages of melanoma. A retrospective analysis of the medical records of patients suffering from melanoma diagnosed between 2001 and 2011 was carried out at the Department of Dermatology, University of Pécs. Patients with in situ (Stage 0) and metastatic (Stage IV) melanoma were excluded from the analysis, as well as patients who succumbed during the first three years of follow-up. In total, 649 melanoma patients met the inclusion criteria. During the entire follow-up period, 90 recurrences were detected. The vast majority (n = 71; 79%) of the total metastatic cases (n = 90) were diagnosed within the first three years. In 35% of the cases, metastases were detected by CT. Although more than 66% of the CT scans were performed for Stage I patients, only three cases were positive (0.1%) within this population. On the basis of our results, intensive radiological work-up is not deemed necessary during the surveillance of patients in the early stages (IA-IIA) of melanoma. Initial and regular follow-up imaging examinations (preferably CT scans) may be recommended from Stage IIB of the disease.