title: Preoperative imaging for early-stage cutaneous melanoma: predictors, usage, and utility at a single institution.
abstract: BACKGROUND
  Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility.
  
  
  METHODS
  Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectively. Any melanoma-related imaging after diagnosis and before surgery was considered a staging study.
  
  
  RESULTS
  Five hundred fifteen studies were performed in 409 of 546 (75%) patients. Chest x-rays was performed in 70% and advanced imaging in 14% (computed tomography imaging, magnetic resonance imaging, ultrasound, and positron-emission computed tomography imaging). No metastatic lesions were identified. A Breslow thickness greater than 4 mm (odds ratio = 6.46 vs <1 mm; 95% confidence interval, 2.07 to 20.15) and male sex (odds ratio = 2.62 vs female; 95% confidence interval, 1.26 to 5.46) were associated with an increased likelihood of advanced imaging.
  
  
  CONCLUSIONS
  Preoperative imaging was performed in the majority of patients with node-negative melanoma, with 14% undergoing advanced studies. No metastatic lesions were identified, confirming the limited utility in this setting.
authors.affiliation: Department of Surgery, Mayo Clinic in Arizona, 5777 East Mayo Boulevard, Scottsdale, AZ 85250, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Haddad
authors.forename: Erin M
authors.initials: EM
authors.lastname: Garvey
authors.forename: Laurie
authors.initials: L
authors.lastname: Mihalik
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.forename: Nabil
authors.initials: N
authors.lastname: Wasif
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012878:Skin Neoplasms; D014055:Tomography, Emission-Computed / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D000096142:Cutaneous Malignant Melanoma
keywords: Melanoma; Preoperative imaging; Staging