This study aimed to detect metastases in patients with stage III or IV cutaneous melanoma by 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT). Thirty-nine patients with clinically evident stage III or IV melanoma underwent whole-body FDG-PET/CT scans for metastatic disease and these results were compared with those of biopsy. Scans for 38 of the patients were evaluated; one patient's scan could not be evaluated. There were 11 true-positive, two false-positive, 24 true-negative and one false-negative scans for the detection of melanoma metastases, with sensitivity 91%, specificity 92%, accuracy 92%, and positive and negative predictive values 84% and 96%, respectively. False-positive FDG-PET/CT scans were due to sarcoidosis in the lung and infected cyst in the liver. It is concluded that FDG-PET/CT scanning has high sensitivity and specificity for detecting stage III or IV metastatic melanoma.
LangleyRGBBarnhillRLMihmMC: Neoplasms: Cutaneous melanoma. In: Fitzpatrick's Dermatology in General Medicine (FreedbergIMEisenAZWolffK, eds) 6th edn. New York: McGraw-Hill, 2003; pp 917–947.
2.
HallHIMillerDRRogersJD: Update on the incidence and mortality from melanoma in the United States. J Am Acad Dermatol1999; 40: 35–42.
3.
ReintgenDCruseCWWellsK: The orderly progression of melanoma nodal metastases. Ann Surg1994; 220: 759–767.
4.
MeierFWillSEllwangerU: Metastatic pathways and time courses in the orderly progression of cutaneous melanoma. Br J Dermatol2002; 147: 62–70.
5.
SkobeMHambergLMHawighorstT: Concurrent induction of lymphangiogenesis, angiogenesis, and macrophage recruitment by vascular endothelial growth factor-C in melanoma. Am J Pathol2001; 159: 893–903.
6.
LeiterUMeierFSchittekB: The natural course of cutaneous melanoma. J Surg Oncol2004; 86: 172–178.
7.
KingDM: Imaging of metastatic melanoma. Cancer Imaging2006; 6: 204–208.
8.
MirandaEPGertnerMWallJ: Routine imaging of asymptomatic melanoma patients with metastases to sentinel lymph nodes rarely identifies systemic disease. Arch Surg2004; 139: 831–837.
9.
SwetterSCarrollLJohnsonD: Positron emission tomography (PET) is superior to computerized tomography (CT) for metastatic staging in melanoma patients. Clin Positron Imaging2000; 3: 154.
10.
GulecSAFariesMBLeeCC: The role of fluorine-18 deoxyglucose positron emission tomography in the management of patients with metastatic melanoma: Impact on surgical decision. Clin Nucl Med2003; 28: 961–965.
11.
JadvarHJohnsonDLSegallGM: The effect of fluorine-18 fluorodeoxyglucose positron emission tomography on the management of cutaneous malignant melanoma. Clin Nucl Med2000; 25: 48–51.
12.
SchwimmerJEssnerRPatelA: A review of the literature for wholebody FDG PET in the management of patients with melanoma. Q J Nucl Med2000; 44: 153–167.
13.
SchöderHLarsonSMYeungHW: PET/CT in oncology: Integration into clinical management of lymphoma, melanoma, and gastrointestinal malignancies. J Nucl Med2004; 45 (suppl 1): 72S–81S.
14.
PrichardRSHillADSkehanSJ: Positron emission tomography for staging and management of malignant melanoma. Br J Surg2002; 89: 389–396.
15.
HolderWDJrWhiteRLJrZugerJH: Effectiveness of positron emission tomography for detection of melanoma metastases. Ann Surg1998; 225: 764–771.
16.
RinneDBaumRPHorG: Primary staging and follow-up of high risk melanoma patients with whole-body 18F-fluorodeoxyglucose positron emission tomography. Cancer1998; 82: 1664–1671.
KumarRMaviABuralG: Fluorodeoxyglucose-PET in the management of malignant melanoma. Radiol Clin North Am2005; 43: 23–33.
22.
ReinhardtMJJoeAYJaegerU: Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol2006; 24: 1178–1187.
23.
MijnhoutGSHoekstraOSvan TulderMW: Systematic review of the diagnostic accuracy of 18F-FDG PET in melanoma patients. Cancer2001; 91: 1530–1542.
24.
MacapinlacHA: FDG PET and PET/CT imaging in lymphoma and melanoma. Cancer J2004; 10: 262–270.
25.
FreudenbergLSSchuelerAOBeyerT: Whole-body fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in staging of advanced uveal melanoma. Surv Ophthalmol2004; 49: 537–540.
26.
FingerPTKurliMReddyS: Whole-body PET/CT for initial staging of choroidal melanoma. Br J Ophthalmol2005; 89: 1270–1274.
27.
KamelEMThumshirnMTruningerK: Significance of incidental 18FFDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med2004; 45: 1804–1810.
28.
BrandCUEllwangerUStroebelW: Prolonged survival of 2 years or longer for patients with disseminated melanoma: An analysis of related prognostic factors. Cancer1997; 70: 2345–2353.
29.
MeyerTMerkelSGoehlJ: Surgical therapy for distant metastases of malignant melanoma. Cancer2000; 89: 1983–1991.
30.
StasMStroobantsSDupontP: 18-FDG PET scan in the staging of recurrent melanoma: Additional value and therapeutic impact. Melanoma Res2002; 12: 479–490.
31.
SwetterSMCarrollLAJohnsonDL: Positron emission tomography is superior to computed tomography for metastatic detection in melanoma patients. Ann Surg Oncol2002; 9: 646–653.
32.
WongCSilvermanDHSeltzerM: The impact of 2-deoxy-2[18F]fluoro-D-glucose whole body positron emission tomography for managing patients with melanoma: the referring physician's perspective. Mol Imaging Biol2002; 4: 185–190.
33.
JadvarHJohnsonDLSegallGM: The effect of fluorine-18 fluorodeoxyglucose positron emission tomography on the management of cutaneous malignant melanoma. Clin Nucl Med2000; 25: 48–51.
34.
LarcosGMaiseyMN: FDG-PET screening for cerebral metastases in patients with suspected malignancy. Nucl Med Commun1996; 17: 197–198.
35.
PatzEFJrLoweVJHoffmanJM: Focal pulmonary abnormalities: Evaluation with F-18 fluorodeoxyglucose PET scanning. Radiology1993; 188: 487–490.
36.
AvrilNDoseJJanickeF: Metabolic characterization of breast tumors with positron emission tomography using F-18 fluorodeoxyglucose. J Clin Oncol1996; 14: 1848–1857.
37.
LoweVJFletcherJWGobarL: Prospective investigation of positron emission tomography in lung nodules. J Clin Oncol1998; 16: 1075–1084.
