title: Value of positron emission tomography scan in stage III cutaneous melanoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The objective of this study was to review the collective experience and utility of FDG-PET scans (FDG-PET) in the detection of systemic metastases in patients with stage III melanoma.
  
  
  METHODS
  A systematic search for relevant studies published between 1990 and 2012 was performed. We included English language studies that evaluated melanoma patients with stage III disease, with at least 10 patients per study, and collected statistical data to assess FDG-PET utility in the detection of distant metastases. The SIGN tool was used to evaluate methodological quality and a meta-analysis was performed using Stata statistical software to quantify the clinical utility of FDG-PET.
  
  
  RESULTS
  The systematic search yielded 9 studies eligible for inclusion in quantitative analyses with a total of 623 patients. The overall sensitivity of FDG-PET in detecting systemic metastases was 89.42% (95% CI: 65.07-97.46), and specificity was 88.78% (95% CI: 77.04-94.91). The pooled positive likelihood ratio was 7.97 (95% CI: 3.58-17.71) and the negative likelihood ratio was 0.12 (95% CI: 0.03-0.47). The area under the summary receiver operating curve (SROC) was 0.94 (95% CI: 0.92-0.96) and the diagnostic odds ratio (DOR) was 66.84 (95% CI: 10.66-418.89). A change in stage and/or management was noted in 22% (126/573) of patients when FDG-PET was utilized.
  
  
  CONCLUSIONS
  Our findings indicate that FDG-PET may be useful in detecting distant metastases in patients with stage III melanoma. For this highly selected group of patients, FDG-PET has a high sensitivity, specificity and performance, frequently leading to a change in treatment plan.
authors.affiliation: Department of Oncology, McGill University, Montreal, QC, Canada; Department of Surgery, McGill University, Montreal, QC, Canada.
authors.forename: Angel M
authors.initials: AM
authors.lastname: Rodriguez Rivera
authors.affiliation: Department of Surgery, McGill University, Montreal, QC, Canada; Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.
authors.forename: Haytham
authors.initials: H
authors.lastname: Alabbas
authors.affiliation: Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada; Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.
authors.forename: Aliya
authors.initials: A
authors.lastname: Ramjaun
authors.affiliation: Department of Oncology, McGill University, Montreal, QC, Canada; Department of Surgery, McGill University, Montreal, QC, Canada; Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada. Electronic address: ari.meguerditchian@mcgill.ca.
authors.forename: Ari-Nareg
authors.initials: AN
authors.lastname: Meguerditchian
mesh_terms: D019788:Fluorodeoxyglucose F18; D006801:Humans; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Fluorodeoxyglucose F18; Melanoma cutaneous malignant; Neoplasm metastasis; Positron emission tomography