title: Role of 18F-FDG PET/CT in the diagnosis of clinically suspected Marjolin ulcer.
abstract: OBJECTIVE
  The purpose of our study is to retrospectively determine the diagnostic role of (18)F-FDG PET/CT at the primary lesion site in burned patients with chronic nonhealing ulcers who are suspected of having Marjolin ulcers.
  
  
  METHODS
  Thirty-three burn scar contractures with nonhealing chronic ulcer in 28 patients were included in this study. The lesions were sorted into two groups: 22 squamous cell carcinomas and one basal cell carcinoma were assigned to group 1 (Marjolin ulcer), and 10 lesions of chronic ulcer with inflammation and fibrosis were assigned to group 2. The maximum standardized uptake value (SUV(max)) and the lesion thickness and size for the two groups were evaluated. To determine the utility of PET/CT in the evaluation of invasion depth, we compared the imaging findings of PET/CT with surgical or pathologic results and the findings of additional imaging modalities, such as CT or MRI.
  
  
  RESULTS
  The SUV(max) and the lesion thickness for group 1 were significantly higher than those for group 2 (p < 0.01 and p = 0.03, respectively). The sensitivity, specificity, and area under the receiver operating characteristic curve were 82.6%, 90%, and 0.900, respectively, for SUV(max) and 65.2%, 80%, and 0.741, respectively, for lesion thickness. PET/CT was helpful and showed quite good correlation with surgical or pathologic results in determining invasion depth.
  
  
  CONCLUSIONS
  PET/CT is useful in differentiating Marjolin ulcer from benign inflammatory conditions of chronic nonhealing ulcer in burn scars. It is also useful in the evaluation of the depth of invasion in Marjolin ulcer cases.
authors.affiliation: Department of Radiology, Hallym University Hangang Sacred Heart Hospital, 94-200 Yeongdeungpo-dong 2-ga, Yeongdeungpo-gu, Seoul 150-719, Korea.
authors.forename: Younghwan
authors.initials: Y
authors.lastname: Ko
authors.forename: You Mie
authors.initials: YM
authors.lastname: Han
authors.forename: Hee Sung
authors.initials: HS
authors.lastname: Hwang
authors.forename: Ik Won
authors.initials: IW
authors.lastname: Kang
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Hwang
authors.forename: Eil Seong
authors.initials: ES
authors.lastname: Lee
authors.forename: Gyung Kyu
authors.initials: GK
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D002908:Chronic Disease; D003286:Contracture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012871:Skin Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D012883:Skin Ulcer / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18