Journal of the European Academy of Dermatology and Venereology : JEADV · 2015
Diagnostic accuracy of (18)F-FDG-PET/CT in early and late stages of high-risk cutaneous malignant melanoma.
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Gellén E, Sántha O, Janka E, Juhász I, Péter Z, Erdei I, Lukács R, Fedinecz N, Galuska L, Remenyik É, Emri G
Аннотация
BACKGROUND: The precise role of total body (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) in the clinical management of patients with cutaneous malignant melanoma (CMM) is not well established.
OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of PET/CT in early- and late-stage patients with high-risk CMM.
METHODS: We retrospectively analysed various imaging, histopathological and clinical data from 97 patients also examined by PET/CT during a 5-year period (2007-2011). Three groups were assessed: stage I/II, resected stage III and unresectable stage III/stage IV.
RESULTS: The median follow-up time of living patients was 43.48 ± 19.67 (15-142) months. We observed a high diagnostic accuracy in all stages (91.3%, 92.5% and 96.2% respectively). PET/CT appeared to be reliable diagnostic tool even for the detection of small lymph node metastases. PET/CT was informative in 14 of 19 cases wherein another imaging examination provided inconclusive results regarding lesion dignity. However, PET/CT was less suitable for properly evaluating the dignity of a lung lesion. A true positive scan was twice as likely in clinically negative patients with resected stage III disease than in patients with stage I/II disease (35.9% and 14.5%, P = 0.007).
CONCLUSIONS: These results confirm that PET/CT is an important diagnostic tool in the management of patients with high-risk CMM, but it cannot replace the standard of care examinations. More accurate clinicopathological and timing criteria must be defined to best utilize the advantages of this imaging method.
OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of PET/CT in early- and late-stage patients with high-risk CMM.
METHODS: We retrospectively analysed various imaging, histopathological and clinical data from 97 patients also examined by PET/CT during a 5-year period (2007-2011). Three groups were assessed: stage I/II, resected stage III and unresectable stage III/stage IV.
RESULTS: The median follow-up time of living patients was 43.48 ± 19.67 (15-142) months. We observed a high diagnostic accuracy in all stages (91.3%, 92.5% and 96.2% respectively). PET/CT appeared to be reliable diagnostic tool even for the detection of small lymph node metastases. PET/CT was informative in 14 of 19 cases wherein another imaging examination provided inconclusive results regarding lesion dignity. However, PET/CT was less suitable for properly evaluating the dignity of a lung lesion. A true positive scan was twice as likely in clinically negative patients with resected stage III disease than in patients with stage I/II disease (35.9% and 14.5%, P = 0.007).
CONCLUSIONS: These results confirm that PET/CT is an important diagnostic tool in the management of patients with high-risk CMM, but it cannot replace the standard of care examinations. More accurate clinicopathological and timing criteria must be defined to best utilize the advantages of this imaging method.
Предметные рубрики MeSH
AdultAgedAged, 80 and overFalse Negative ReactionsFalse Positive ReactionsFemaleFluorodeoxyglucose F18HumansLymphatic MetastasisMaleMelanomaMiddle AgedMultimodal ImagingNeoplasm StagingPositron-Emission TomographyRadiopharmaceuticalsRetrospective StudiesRisk FactorsSensitivity and SpecificitySkin NeoplasmsTomography, X-Ray ComputedYoung Adult