Utility of preoperative [(18)]F Fluorodeoxyglucose-positron emission tomography scanning in high-risk melanoma patients Journal Article


Authors: Brady, M. S.; Akhurst, T.; Spanknebel, K.; Hilton, S.; Gonen, M.; Patel, A.; Larson, S.
Article Title: Utility of preoperative [(18)]F Fluorodeoxyglucose-positron emission tomography scanning in high-risk melanoma patients
Abstract: 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. © 2006 The Society of Surgical Oncology, Inc.
Keywords: adult; aged; aged, 80 and over; middle aged; major clinical study; clinical trial; cancer risk; cancer patient; preoperative care; nuclear magnetic resonance imaging; positron emission tomography; follow up; diagnostic accuracy; sensitivity and specificity; prospective studies; radiopharmaceuticals; medical decision making; reproducibility of results; melanoma; metastasis; computer assisted tomography; skin neoplasms; diagnostic imaging; high risk patient; imaging system; medical information; preoperative period; diagnostic value; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; diagnostic test; management; tomography, emission-computed; occult cancer; preoperative; high risk; [(18)]f fluorodeoxyglucose-positron emission tomography scanning; whole body tomography
Journal Title: Annals of Surgical Oncology
Volume: 13
Issue: 4
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2006-04-01
Start Page: 525
End Page: 532
Language: English
DOI: 10.1245/aso.2006.02.008
PUBMED: 16474909
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 40" - "Export Date: 4 June 2012" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Mithat Gonen
    1030 Gonen
  2. Timothy J Akhurst
    139 Akhurst
  3. Mary Sue Brady
    203 Brady
  4. Steven M Larson
    959 Larson
  5. Ami Patel
    24 Patel