title: F-18-fluoro-2-deoxyglucose positron emission tomography (PET) and PET/computed tomography imaging in primary staging of patients with malignant melanoma: a systematic review.
abstract: OBJECTIVE
  The aim of this systematic review was to systematically assess the potential patient-relevant benefit (primary aim) and diagnostic and prognostic accuracy (secondary aim) of positron emission tomography (PET) and PET/computed tomography (CT) in primary staging of malignant melanoma. This systematic review updates the previous evidence for PET(/CT) in malignant melanoma.
  
  
  METHODS
  For the first aim, randomized controlled trials (RCTs) investigating patient-relevant outcomes and comparing PET and PET(/CT) with each other or with conventional imaging were considered. For the secondary aim, a review of reviews was conducted, which was amended by an update search for primary studies. MEDLINE, EMBASE and four databases of the Cochrane Library were searched. The risk of bias was assessed using a modified QUADAS tool.
  
  
  RESULTS
  No RCTs investigating the patient-relevant benefit of PET(/CT) and no prognostic accuracy studies were found. Seventeen diagnostic accuracy studies of varying quality were identified. For patients with American Joint Committee on Cancer (AJCC) stages I and II, sensitivity mostly ranged from 0 to 67%. Specificity ranged from 77 to 100%. For AJCC stages III and IV, sensitivity ranged from 68 to 87% and specificity from 92 to 98%.
  
  
  CONCLUSIONS
  There is currently no evidence of a patient-relevant benefit of PET(/CT) in the primary staging of malignant melanoma. RCTs investigating patient-relevant outcomes are therefore required. The diagnostic accuracy of PET(/CT) appears to increase with higher AJCC stages.
authors.affiliation: Institute for Quality and Efficiency in Health Care, Im Mediapark 8, Cologne, 50670, Germany. milly.schroeer-guenther@iqwig.de
authors.forename: Milly A
authors.initials: MA
authors.lastname: Schröer-Günther
authors.forename: Robert F
authors.initials: RF
authors.lastname: Wolff
authors.forename: Marie E
authors.initials: ME
authors.lastname: Westwood
authors.forename: Fülöp J
authors.initials: FJ
authors.lastname: Scheibler
authors.forename: Christoph
authors.initials: C
authors.lastname: Schürmann
authors.forename: Brigitta G
authors.initials: BG
authors.lastname: Baumert
authors.forename: Stefan
authors.initials: S
authors.lastname: Sauerland
authors.forename: Jos
authors.initials: J
authors.lastname: Kleijnen
mesh_terms: D019788:Fluorodeoxyglucose F18; D006801:Humans; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016032:Randomized Controlled Trials as Topic; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18