Oncology Medical News about melanoma;palpable lymph node metastases;18F Fluorodeoxyglucose positron emission tomography

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Prospective comparison of [18F]fluorodeoxyglucose positron emission tomography and computed tomography in patients with melanoma with palpable lymph node metastases: diagnostic accuracy and impact on treatment
Journal of Clinical Oncology, 09/04/09

Bastiaannet E et al. – As a result of FDG-PET and CT, 27% of patients were upstaged, and treatment changed in one of five patients. FDG-PET and CT are equivalent in upstaging; however, FDG-PET detected more metastatic sites, especially bone and subcutaneous. FDG-PET and/or CT are indicated in the staging of patients with melanoma with palpable lymph node metastases.

Methods

All consecutive patients with palpable, proven lymph node metastases of melanoma between mid 2003 and 2007 were prospectively included
The number/site of distant metastases detected with FDG-PET and CT were recorded
Histology/cytology or 6 months follow-up were the reference standard

Results

Distant metastases were suspected by FDG-PET in 32% of the 251 patients and by CT in 29%
Upstaging was correct in 27% by FDG-PET and in 24% by CT
FDG-PET detected more metastatic sites (133 v 112), detecting significantly more bone and subcutaneous metastases
Treatment changed in 19% of patients; in 79% as a result of both scans, in 17% exclusively by FDG-PET, and in 4% exclusively by CT
In 34 patients (14%), FDG-PET had an additional value over spiral CT, and in 23 patients (9%), CT had additional value over FDG-PET

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