title: Routine positron emission tomography and positron emission tomography/computed tomography in melanoma staging with positive sentinel node biopsy is of limited benefit.
abstract: Positron emission tomography (PET) is increasingly used for the staging and management of melanoma. The aim of this study was to evaluate the role of PET or PET/ computed tomography (CT) as a routine procedure in patients with positive sentinel node biopsy (SNB). Thirty patients with melanoma of Breslow thickness greater than 1 mm who had PET or PET/CT scans performed within 100 days after a positive SNB were reviewed retrospectively. Two patients (6%) had a positive PET scan, none of which were melanoma related. The first patient had a synchronous neuroendocrine thyroid tumour and the second patient had increased uptake in the chest wall, which proved to be old trauma. Lymph node dissection was positive in five cases (16%). With a median follow-up of 24 months, 21 patients remained disease free. In none of the 30 cases did the early PET scan after a positive SNB alter subsequent melanoma management. The role of PET scanning soon after a positive sentinel node biopsy seems to be of limited benefit. It is questionable whether any imaging is beneficial at this stage. The results of this review suggest that PET scanning might not be indicated for this group of patients.
authors.affiliation: Melanoma Unit, Guy's and St Thomas' Foundation NHS Trust, London, UK. a.constantinidou@yahoo.co.uk
authors.forename: Anastasia
authors.initials: A
authors.lastname: Constantinidou
authors.forename: Michael
authors.initials: M
authors.lastname: Hofman
authors.forename: Michael
authors.initials: M
authors.lastname: O'Doherty
authors.forename: Katharine M
authors.initials: KM
authors.lastname: Acland
authors.forename: Ciaran
authors.initials: C
authors.lastname: Healy
authors.forename: Mark
authors.initials: M
authors.lastname: Harries
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000209:etiology / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D035441:Thoracic Wall / Q000473:pathology; D013964:Thyroid Neoplasms / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*