title: Prognostic value of [18F]-fluoro-deoxy-glucose PET/CT, S100 or MIA for assessment of cancer-associated mortality in patients with high risk melanoma.
abstract: OBJECTIVE
  To assess the prognostic value of FDG PET/CT compared to the tumor markers S100B and melanoma inhibitory activity (MIA) in patients with high risk melanoma.
  
  
  METHODS
  Retrospective study in 125 consecutive patients with high risk melanoma that underwent FDG PET/CT for re-staging. Diagnostic accuracy and prognostic value was determined for FDG PET/CT as well as for S100B and MIA. As standard of reference, cytological, histological, PET/CT or MRI follow-up findings as well as clinical follow-up were used.
  
  
  RESULTS
  Of 125 patients, FDG PET/CT was positive in 62 patients. 37 (29.6%) patients had elevated S100B (>100 pg/ml) and 24 (20.2%) had elevated MIA (>10 pg/ml) values. Overall specificities for FDG PET/CT, S100B and MIA were 96.8% (95% CI, 89.1% to 99.1%), 85.7% (75.0% to 92.3%), and 95.2% (86.9% to 98.4%), corresponding sensitivities were 96.8% (89.0% to 99.1%), 45.2% (33.4% to 55.5%), and 36.1% (25.2% to 48.6%), respectively. The negative predictive values (NPV) for PET/CT, S100B, and MIA were 96.8% (89.1% to 99.1%), 61.4% (50.9% to 70.9%), and 60.6% (50.8% to 69.7%). The positive predictive values (PPV) were 96.7% (89.0% to 99.1%), 75.7% (59.9% to 86.6%), and 88.0% (70.0% to 95.8%). Patients with elevated S100B- or MIA values or PET/CT positive findings showed a significantly (p<0.001 each, univariate Cox regression models) higher risk of melanoma associated death which was increased 4.2-, 6.5- or 17.2-fold, respectively.
  
  
  CONCLUSIONS
  PET/CT has a higher prognostic power in the assessment of cancer-associated mortality in melanoma patients compared with S100 and MIA.
authors.affiliation: Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts-der-Isar, Technische Universität München, München, Germany. Markus.Essler@gmx.de
authors.forename: Markus
authors.initials: M
authors.lastname: Essler
authors.forename: Anna
authors.initials: A
authors.lastname: Link
authors.forename: Benedetta
authors.initials: B
authors.lastname: Belloni
authors.forename: Vesna
authors.initials: V
authors.lastname: Mirceva
authors.forename: Michael
authors.initials: M
authors.lastname: Souvatzoglou
authors.forename: Markus
authors.initials: M
authors.lastname: Thaler
authors.forename: Bernhard
authors.initials: B
authors.lastname: Haller
authors.forename: Ruediger
authors.initials: R
authors.lastname: Hein
authors.forename: Bernd J
authors.initials: BJ
authors.lastname: Krause
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016326:Extracellular Matrix Proteins / Q000032:analysis*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008545:Melanoma / Q000378:metabolism* / Q000401:mortality*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D009418:S100 Proteins / Q000032:analysis*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D016326:Extracellular Matrix Proteins; C090059:MIA protein, human; D009363:Neoplasm Proteins; D009418:S100 Proteins; D019788:Fluorodeoxyglucose F18