title: HF ultrasound vs PET-CT and telethermography in the diagnosis of In-transit metastases from melanoma: a prospective study and review of the literature.
abstract: BACKGROUND
  Over the past several years the incidence of cutaneous melanoma has rapidly increased. This tumor develops often in-transit metastases that significantly reduce patient survival at 5 years. To improve prognosis and quality of life in patients with melanoma metastases, a mini invasive procedure like electrochemotherapy (ECT) is adopted to remove superficial tissue lesions. To detect the melanoma metastases, high frequency (HF) ultrasound (US) is used. This technique, though, can be time-consuming and it needs an expert operator and a high performing machine. Therefore, we asked whether the US could be replaced or integrated with other less time-consuming techniques such as 18-FDG positron emission tomography/computed tomography (PET-CT) and telethermography (TT).
  
  
  METHODS
  Fifteen patients (4 males and 11 females - age range: 63-91) affected whit advanced stage melanoma were enrolled. They presented 52 in-transit metastases as detected by the three techniques used, HF-US, PET/CT and TT within 30 days before ECT.
  
  
  RESULTS
  All the 52 lesions were detected by HF-US (100%), 24/52 were detected by PET-CT (42,6%) and 15/52 were detected by TT (27,7%). PET-CT reported 3.7% false positives, while no false positive were reported by TT.
  
  
  CONCLUSIONS
  As US detected 100% lesions, compared to the other two techniques used, US, along with clinical examination, has still to be considered as gold standard in the diagnosis of metastatic lesions. US, associated with an exhaustive anamnesis and accurate clinical examination, cannot be replaced by either PET-CT or TT. When US performing devices and experienced operators are not available, though, it is highly recommended to integrate US with at least one of the other techniques. Under certain circumstances, as in the case of obese and non-collaborating patients or in patients with lymphatic stasis, these techniques should be integrated to obtain exact in-transit metastases evaluation.
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Solivetti
authors.forename: Flora
authors.initials: F
authors.lastname: Desiderio
authors.forename: Antonino
authors.initials: A
authors.lastname: Guerrisi
authors.forename: Antonio
authors.initials: A
authors.lastname: Bonadies
authors.forename: Carlo Ludovico
authors.initials: CL
authors.lastname: Maini
authors.forename: Simona
authors.initials: S
authors.lastname: Di Filippo
authors.forename: Valerio
authors.initials: V
authors.lastname: D'Orazi
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.forename: Aldo
authors.initials: A
authors.lastname: Di Carlo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D012878:Skin Neoplasms; D013817:Thermography / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography; D000096142:Cutaneous Malignant Melanoma