title: Direct comparison of [18F]FDG PET/CT with PET alone and with side-by-side PET and CT in patients with malignant melanoma.
abstract: OBJECTIVE
  The purpose of this retrospective, blinded study was to evaluate the additional value of [18F]FDG PET/CT in comparison with PET alone and with side-by-side PET and CT in patients with malignant melanoma (MM).
  
  
  METHODS
  A total of 127 consecutive studies of patients with known MM referred for a whole-body PET/CT examination were included in this study. PET alone, side-by-side PET and CT and integrated PET/CT study were independently and separately interpreted without awareness of the clinical information. One score each was applied for certainty of lesion localisation and for certainty of lesion characterisation. Verification of the findings was subsequently performed using all available clinical, pathological (n=30) and follow-up information.
  
  
  RESULTS
  The number of lesions with an uncertain localisation was significantly (p<0.001) reduced by PET/CT and side-by-side PET and CT (p<0.05) in comparison with PET alone. In line with this increase in certainty integrated PET/CT reading also improved certainty in characterisation of lesions, however, this did not reach significance (p=0.057) compared versus PET alone. Respectively, PET, side-by-side PET and CT and PET/CT showed a sensitivity of 86%, 89% and 91%, a specificity of 94%, 94% and 94%, a positive predictive value of 96%, 96% and 96% and a negative predictive value of 80%, 83% and 87%.
  
  
  CONCLUSIONS
  Integrated PET/CT offers a significant benefit in lesion localisation and an improvement in lesion characterisation compared with PET alone or with side-by-side PET and CT. The benefit is not as great as that reported for other tumour entities, which may be due to the high avidity of MM for [18F]FDG.
authors.affiliation: Department of Nuclear Medicine, University Hospital Ulm, Robert-Koch-Strasse 8, 89073, Ulm, Germany. felix.mottaghy@uz.kuleuven.ac.be
authors.forename: Felix M
authors.initials: FM
authors.lastname: Mottaghy
authors.forename: Cord
authors.initials: C
authors.lastname: Sunderkötter
authors.forename: Roland
authors.initials: R
authors.lastname: Schubert
authors.forename: Petra
authors.initials: P
authors.lastname: Wohlfart
authors.forename: Norbert M
authors.initials: NM
authors.lastname: Blumstein
authors.forename: Bernd
authors.initials: B
authors.lastname: Neumaier
authors.forename: Gerhard
authors.initials: G
authors.lastname: Glatting
authors.forename: Cueneyt
authors.initials: C
authors.lastname: Ozdemir
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Buck
authors.forename: Karin
authors.initials: K
authors.lastname: Scharffetter-Kochanek
authors.forename: Sven N
authors.initials: SN
authors.lastname: Reske
mesh_terms: D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009414:Nerve Growth Factors / Q000096:biosynthesis; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D012306:Risk; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000096:biosynthesis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging
chemical_list: D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D019788:Fluorodeoxyglucose F18