title: Capsule endoscopy versus positron emission tomography for detection of small-bowel metastatic melanoma: a pilot study.
abstract: BACKGROUND
  Melanoma is the most common tumor to metastasize to the GI tract, where it mainly involves the small bowel.
  
  
  OBJECTIVE
  To compare capsule endoscopy (CE) and (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT scanning, the current standard and most sensitive investigation modality, in detecting small-bowel metastases in patients with metastatic melanoma.
  
  
  METHODS
  A prospective study of patients with metastatic melanoma who were undergoing FDG PET-CT scanning. CE was performed and the results read by two independent observers without knowledge of the other investigation results.
  
  
  METHODS
  Tertiary care centers.
  
  
  METHODS
  This study involved 21 patients with a median age of 52 years (range 22-88 years).
  
  
  METHODS
  CE.
  
  
  METHODS
  Detection of small-bowel melanoma.
  
  
  RESULTS
  FDG PET-CT scanning showed increased abdominal uptake in 12 patients, but only 5 of these patients were found to have small-bowel melanoma on CE. Importantly, in 1 patient with a bleeding small-bowel tumor on CE, the FDG PET-CT scan result was negative. One patient with positive FDG PET-CT scan results and negative CE results subsequently developed symptomatic small-bowel melanoma 10 months after CE.
  
  
  CONCLUSIONS
  Small-bowel melanoma could not be excluded entirely in 7 patients with positive FDG PET-CT scan results and negative CE results, and follow-up is ongoing. The number of patients in this study was small.
  
  
  CONCLUSIONS
  CE was better than FDG PET-CT scanning in localizing small-bowel melanoma. This study suggests that CE is an ideal complementary investigation modality for patients with known metastatic melanoma undergoing preoperative work-ups and in those with unexplained anemia or GI symptoms.
authors.affiliation: AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Emilia
authors.initials: E
authors.lastname: Prakoso
authors.forename: Michael
authors.initials: M
authors.lastname: Fulham
authors.forename: John F
authors.initials: JF
authors.lastname: Thompson
authors.forename: Warwick S
authors.initials: WS
authors.lastname: Selby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D007421:Intestine, Small; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods; D009517:New South Wales / Q000453:epidemiology; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18