Predictive Value of Preoperative Positron Emission Tomography/Computed Tomography (PET/CT) in Staging of Patients with High-Risk Melanoma.

Accurate staging of high-risk melanoma patients is imperative to ensure effective and appropriate therapy but also to estimate the potential risk of recurrence. Despite numerous studies previously conducted, no consensus has been reached on the optimal posttreatment follow-up method for high-risk melanoma patients. There are no clear indications for PET/CT in follow-up or initial staging of clinically asymptomatic high-risk melanoma patients. The aim of our study was to determine the predictive value of preoperative PET/CT in staging of such patients and its implication on further therapeutic decisions. A retrospective cohort study of 85 patients with T3 and T4 melanoma without clinical signs of nodal involvement or distant metastases was conducted. Patients underwent PET/CT as a part of preoperative staging and results were compared with SLNB. In this study combined sensitivity and specificity of PET/CT for identifying regional and metastatic disease were 54% and 98%, respectively. The positive predictive value (PPV) of PET/CT was 95% while negative predictive value (NPV) was 71%. Preoperative PET/CT changed the treatment plan for 26 patients (31%) Our study showed that PET/CT certainly has a role in the preoperative staging of high-risk melanoma patients, but it also requires a mandatory sentinel lymph node biopsy afterwards.