Ahmed E Othman1, Thomas K Eigentler2, Georg Bier3, Christina Pfannenberg3, Hans Bösmüller4, Christian Thiel5, Claus Garbe2, Konstantin Nikolaou3, Bernhard Klumpp3. 1. Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany. ahmed.e.othman@googlemail.com. 2. Department of Dermatology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, 72076, Tuebingen, Germany. 3. Department of Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany. 4. Institute of Pathology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, 72076, Tuebingen, Germany. 5. Department of General, Visceral and Transplantation Surgery, Eberhard Karls University Tuebingen, University Hospital Tuebingen, 72076, Tuebingen, Germany.
Abstract
OBJECTIVE: To assess the appearance of gastrointestinal melanoma metastases on CT and PET/CT and evaluate the diagnostic value of CT and PET/CT compared with surgery and histopathology. METHODS: We retrospectively included 41 consecutive patients (aged 56.1 ± 13.5 years) with gastrointestinal melanoma metastases who underwent preoperative imaging (CT: all, PET/CT: n = 24) and metastasectomy. Two blinded radiologists assessed CT and PET/CT for gastrointestinal metastases and complications. Diagnostic accuracy and differences regarding lesion detectability and complications were assessed, using surgical findings and histopathology as standard of reference. RESULTS: Fifty-three gastrointestinal melanoma metastases (5.0 ± 3.8 cm) were confirmed by surgery and histopathology. Lesions were located in the small bowel (81.1 %), colon (15.1 %) and stomach (3.8 %), and described as infiltrating (30.2 %), polypoid (28.3 %), cavitary (24.5 %) and exoenteric (17.0 %). Fifteen patients (37 %) had gastrointestinal complications. Higher complication rates were associated with large and polypoid lesions (p ≤ .012). Diagnostic accuracy was high for CT and PET/CT (AUC ≥ .802). For reader B (less experienced), CT yielded lower diagnostic accuracy than PET/CT (p = .044). CONCLUSION: Most gastrointestinal melanoma metastases were located in the small bowel. Large and polypoid metastases were associated with higher complication rates. PET/CT was superior for detection of gastrointestinal melanoma metastases and should be considered in patients with limited disease undergoing surgery. KEY POINTS: • Gastrointestinal melanoma metastases (GI-MM) are rare but often cause serious gastrointestinal complications. • Early detection of GI-MM is important to prevent complications and guide surgery. • PET/CT is superior to CT for detection of GI-MMs. • PET/CT should be considered for patients with limited disease before surgical resection.
OBJECTIVE: To assess the appearance of gastrointestinal melanoma metastases on CT and PET/CT and evaluate the diagnostic value of CT and PET/CT compared with surgery and histopathology. METHODS: We retrospectively included 41 consecutive patients (aged 56.1 ± 13.5 years) with gastrointestinal melanoma metastases who underwent preoperative imaging (CT: all, PET/CT: n = 24) and metastasectomy. Two blinded radiologists assessed CT and PET/CT for gastrointestinal metastases and complications. Diagnostic accuracy and differences regarding lesion detectability and complications were assessed, using surgical findings and histopathology as standard of reference. RESULTS: Fifty-three gastrointestinal melanoma metastases (5.0 ± 3.8 cm) were confirmed by surgery and histopathology. Lesions were located in the small bowel (81.1 %), colon (15.1 %) and stomach (3.8 %), and described as infiltrating (30.2 %), polypoid (28.3 %), cavitary (24.5 %) and exoenteric (17.0 %). Fifteen patients (37 %) had gastrointestinal complications. Higher complication rates were associated with large and polypoid lesions (p ≤ .012). Diagnostic accuracy was high for CT and PET/CT (AUC ≥ .802). For reader B (less experienced), CT yielded lower diagnostic accuracy than PET/CT (p = .044). CONCLUSION: Most gastrointestinal melanoma metastases were located in the small bowel. Large and polypoid metastases were associated with higher complication rates. PET/CT was superior for detection of gastrointestinal melanoma metastases and should be considered in patients with limited disease undergoing surgery. KEY POINTS: • Gastrointestinal melanoma metastases (GI-MM) are rare but often cause serious gastrointestinal complications. • Early detection of GI-MM is important to prevent complications and guide surgery. • PET/CT is superior to CT for detection of GI-MMs. • PET/CT should be considered for patients with limited disease before surgical resection.
Authors: Konstantinos Kouladouros; Daniel Gärtner; Steffen Münch; Mario Paul; Michael R Schön Journal: World J Gastroenterol Date: 2015-03-14 Impact factor: 5.742
Authors: Eva Mendes Serrao; Ana Maria Costa; Sergio Ferreira; Victoria McMorran; Emma Cargill; Caroline Hough; Ashley S Shaw; Brent O'Carrigan; Christine A Parkinson; Pippa G Corrie; Timothy J Sadler Journal: Insights Imaging Date: 2022-10-04
Authors: Eva Mendes Serrao; Emily Joslin; Victoria McMorran; Caroline Hough; Cheryl Palmer; Sarah McDonald; Emma Cargill; Ashley S Shaw; Brent O'Carrigan; Christine A Parkinson; Pippa G Corrie; Timothy J Sadler Journal: Cancer Imaging Date: 2022-06-14 Impact factor: 5.605