BACKGROUND: [(18)]F Fluorodeoxyglucose-positron emission tomography (PET) scanning provides functional imaging based on glucose uptake by tumors. Melanoma is a glucose-avid malignancy, and preoperative PET scanning in melanoma patients has the potential to guide appropriate treatment. METHODS: We performed a prospective trial to evaluate the clinical utility of whole-body fluorine 18-labeled deoxyglucose-PET scanning used in addition to standard imaging (contrast-enhanced computed tomographic [CT] imaging of the chest, abdomen, and pelvis) in preoperative stage IIC (T4N0M0), III (any T, N1 to N3, M0), and IV (any T, any N, M1) melanoma patients. Pathologic or clinical follow-up within 4 to 6 months of the imaging studies was used to determine the accuracy of preoperative PET and CT scan findings. RESULTS: Preoperative imaging findings led to a change in clinical management in 36 (35%) of 103 patients. In 32 (89%) of these patients, the information was accurate. Findings on PET scan alone (14 of 36; 39%) or in combination with CT (20 of 36; 56%) resulted in a treatment change in most patients (34 of 36; 94%). The most common decision was to cancel the operation (19 of 36; 53%). PET scanning was more sensitive than CT scanning in detecting occult disease (68% vs. 48%; P=.05), but both tests were highly specific (92% vs. 95%; P=.7, PET vs. CT). CONCLUSIONS: PET scanning facilitates the appropriate management of high-risk melanoma patients being considered for operative intervention. PET imaging in addition to CT scanning should be strongly considered before operation in patients at high risk for occult metastatic disease.
BACKGROUND: [(18)]F Fluorodeoxyglucose-positron emission tomography (PET) scanning provides functional imaging based on glucose uptake by tumors. Melanoma is a glucose-avid malignancy, and preoperative PET scanning in melanomapatients has the potential to guide appropriate treatment. METHODS: We performed a prospective trial to evaluate the clinical utility of whole-body fluorine 18-labeled deoxyglucose-PET scanning used in addition to standard imaging (contrast-enhanced computed tomographic [CT] imaging of the chest, abdomen, and pelvis) in preoperative stage IIC (T4N0M0), III (any T, N1 to N3, M0), and IV (any T, any N, M1) melanomapatients. Pathologic or clinical follow-up within 4 to 6 months of the imaging studies was used to determine the accuracy of preoperative PET and CT scan findings. RESULTS: Preoperative imaging findings led to a change in clinical management in 36 (35%) of 103 patients. In 32 (89%) of these patients, the information was accurate. Findings on PET scan alone (14 of 36; 39%) or in combination with CT (20 of 36; 56%) resulted in a treatment change in most patients (34 of 36; 94%). The most common decision was to cancel the operation (19 of 36; 53%). PET scanning was more sensitive than CT scanning in detecting occult disease (68% vs. 48%; P=.05), but both tests were highly specific (92% vs. 95%; P=.7, PET vs. CT). CONCLUSIONS: PET scanning facilitates the appropriate management of high-risk melanomapatients being considered for operative intervention. PET imaging in addition to CT scanning should be strongly considered before operation in patients at high risk for occult metastatic disease.
Authors: Yan Xing; Yulia Bronstein; Merrick I Ross; Robert L Askew; Jeffrey E Lee; Jeffrey E Gershenwald; Richard Royal; Janice N Cormier Journal: J Natl Cancer Inst Date: 2010-11-16 Impact factor: 13.506
Authors: Georgia M Beasley; Colin Parsons; Gloria Broadwater; M Angelica Selim; Suroosh Marzban; Amy P Abernethy; April K S Salama; Edward A Eikman; Terence Wong; Jonathan S Zager; Douglas S Tyler Journal: Ann Surg Date: 2012-08 Impact factor: 12.969
Authors: Stephen P Povoski; Ryan L Neff; Cathy M Mojzisik; David M O'Malley; George H Hinkle; Nathan C Hall; Douglas A Murrey; Michael V Knopp; Edward W Martin Journal: World J Surg Oncol Date: 2009-01-27 Impact factor: 2.754
Authors: Dana Yip; Maithao N Le; Joseph L-K Chan; Jonathan H Lee; Janice A Mehnert; Anthony Yudd; Jeffery Kempf; Weichung J Shih; Suzie Chen; James S Goydos Journal: Clin Cancer Res Date: 2009-05-19 Impact factor: 12.531
Authors: Milly A Schröer-Günther; Robert F Wolff; Marie E Westwood; Fülöp J Scheibler; Christoph Schürmann; Brigitta G Baumert; Stefan Sauerland; Jos Kleijnen Journal: Syst Rev Date: 2012-12-13