[PET scanning for malignant melanoma and positive sentinel node diagnostics].
BACKGROUND
To illuminate the value of using positron emission tomography (PET) scan as a clinical routine screening procedure for detecting subclinical metastases in melanoma patients with positive sentinel node biopsy, we carried out a retrospective study which included a total of 80 patients.


METHODS
80 patients with cutaneous malignant melanoma and subclinical lymph node metastases diagnosed by sentinel node biopsy (SNB) were submitted to 18F-fluoro-2-deoxy-D-glucose (FDG) whole-body PET-scanning within 100 days after SNB and wide local excision (WLE). Before FDG-PET scanning, patients were screened conventionally and found to be without evidence of further dissemination. The average follow-up was 30 months (range 7-81 months).


RESULTS
13 patients out of totally 80 patients had a suspicious FDG-PET scan. 4 of these patients (5%) were found true positive by verifying examinations. 67 patients had a negative FDG-PET scan - 4 of these patients developed a clinical recurrence within a period of 6 months after SNB (false negative). This resulted in a sensitivity of 50% and a specificity of 31%.


CONCLUSIONS
We conclude that FDG-PET scanning in connection with SNB cannot be recommended as a routine investigation for patients with malignant melanoma and positive SNB.
Horn
Janne
J
Roskilde Sygehus, Plastikkirurgisk Afdeling, og Rigshospitalet, Diagnostisk Center, PET-og Cyclotronenheden, Denmark. janne@horn.dk
Sjøstrand
Helle
H
Lock-Andersen
Jørgen
J
Loft
Annika
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18