title: Clinical impact of (18)F-FDG PET-CT in recurrent stage III/IV melanoma: a tertiary centre Specialist Skin Cancer Multidisciplinary Team (SSMDT) experience.
abstract: OBJECTIVE
  To assess the clinical impact of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) compared with contrast-enhanced computed tomography (CECT) in patients referred via the Specialist Skin Cancer Multidisciplinary Team (SSMDT) with recurrent stage III/IV malignant melanoma (MM).
  
  
  METHODS
  Forty-five patients were referred for further evaluation with FDG PET-CT. Findings on FDG PET-CT were compared with prior CECT and the clinical impact on subsequent management decisions was determined retrospectively. A major clinical impact was defined as a change in treatment plan resulting from identification of additional sites of disease or by characterisation of indeterminate findings on prior imaging. A minor impact was defined as confirmation of known sites of disease as identified on prior CECT.
  
  
  RESULTS
  Fifty-one PET-CT examinations were performed. FDG PET-CT had a major clinical impact in 21 cases (41.2 %), of which 18 examinations were performed in patients with proven or suspected stage IV MM. FDG PET-CT had a minor impact in 23 cases (45.1 %), and there were five false-positive cases (9.8 %) and two false-negative cases (3.9 %).
  
  
  CONCLUSIONS
  FDG PET-CT is an effective tool in recurrent stage III/IV MM with a significant clinical impact on management decisions in patients who are appropriately referred via the highly specialised forum of the SSMDT.
  
  
  CONCLUSIONS
  • FDG PET-CT is an effective tool in recurrent stage III/IV malignant melanoma. • FDG PET-CT has a significant clinical impact on management decisions. • Effective use of FDG PET-CT is via referral from the Specialist Skin Cancer Multidisciplinary Team.
authors.affiliation: Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK, manil.subesinghe@gmail.com.
authors.forename: Manil
authors.initials: M
authors.lastname: Subesinghe
authors.forename: Maria
authors.initials: M
authors.lastname: Marples
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Scarsbrook
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Smith
references.citation: Eur J Nucl Med Mol Imaging. 2007 Sep;34(9):1355-64
references.pmid: 17295038
references.citation: J Clin Oncol. 2006 Mar 1;24(7):1178-87
references.pmid: 16505438
references.citation: Eur J Cancer. 2010 Jan;46(2):270-83
references.pmid: 19959353
references.citation: Nucl Med Commun. 2008 Oct;29(10):847-76
references.pmid: 18769303
references.citation: N Engl J Med. 2011 Jun 30;364(26):2507-16
references.pmid: 21639808
references.citation: J Natl Cancer Inst. 2011 Jan 19;103(2):129-42
references.pmid: 21081714
references.citation: Semin Nucl Med. 2004 Oct;34(4):242-53
references.pmid: 15493002
references.citation: N Engl J Med. 2011 Jun 30;364(26):2517-26
references.pmid: 21639810
references.citation: J Clin Oncol. 2001 Aug 15;19(16):3635-48
references.pmid: 11504745
references.citation: Eur Radiol. 2012 Nov;22(11):2451-7
references.pmid: 22653282
references.citation: Ann Surg Oncol. 2010 Oct;17(10):2773-8
references.pmid: 20422454
references.citation: Ann Surg. 2012 Apr;255(4):771-6
references.pmid: 22367443
references.citation: J Surg Oncol. 2011 Sep;104(4):420-4
references.pmid: 21858837
references.citation: J Natl Compr Canc Netw. 2012 Mar;10(3):366-400
references.pmid: 22393197
references.citation: N Engl J Med. 2010 Aug 19;363(8):711-23
references.pmid: 20525992
references.citation: Eur J Cancer. 2007 Feb;43(3):557-64
references.pmid: 17224266
references.citation: Eur J Nucl Med Mol Imaging. 2010 Feb;37(2):284-300
references.pmid: 19727717
references.citation: AJR Am J Roentgenol. 2012 Apr;198(4):902-8
references.pmid: 22451559
references.citation: Ann Surg. 2002 Jun;235(6):879-87
references.pmid: 12035046
references.citation: Nucl Med Commun. 2007 Apr;28(4):273-80
references.pmid: 17325590
references.citation: J Am Acad Dermatol. 2011 Nov;65(5):1032-47
references.pmid: 21868127
references.citation: Radiology. 2007 Aug;244(2):566-74
references.pmid: 17641374
references.citation: Nucl Med Biol. 1996 Aug;23(6):737-43
references.pmid: 8940715
references.citation: Nucl Med Commun. 2010 Nov;31(11):925-30
references.pmid: 20856153
references.citation: Eur J Nucl Med Mol Imaging. 2011 May;38(5):822-31
references.pmid: 21210112
references.citation: J Dermatol. 2005 May;32(5):316-34
references.pmid: 16043894
references.citation: BMJ. 2012 Apr 26;344:e2718
references.pmid: 22539013
references.citation: Br J Dermatol. 2010 Aug;163(2):238-56
references.pmid: 20608932
references.citation: J Clin Oncol. 2009 Dec 20;27(36):6199-206
references.pmid: 19917835
references.citation: Radiology. 2008 Dec;249(3):836-44
references.pmid: 19011184
references.citation: Acta Oncol. 2010;49(2):192-200
references.pmid: 20059314
references.citation: J Surg Oncol. 2004 Jul 1;86(4):172-8
references.pmid: 15221923