title: Whole body PET/CT in the follow-up of asymptomatic patients with stage IIB-IIIB cutaneous melanoma.
abstract: BACKGROUND
  Whole body positron emission tomography (PET)/computed tomography (CT) is a sensitive imaging technique in patients with metastatic melanoma, but its role in the follow-up of asymptomatic high-risk patients is unclear. The aim was to study the role of PET/CT as a routine surveillance imaging tool in asymptomatic high-risk patients at the early stage of follow-up combined with a sufficient follow-up over several years.
  
  
  METHODS
  A total of 110 asymptomatic patients with clinically local American Joint Committee on Cancer (AJCC) stage IIB-IIIB melanoma underwent routine whole body PET/CT scanning after a mean interval of seven months after initial surgery. Clinical data were retrospectively analyzed after a median follow-up time of 4.6 years.
  
  
  RESULTS
  Recurrent melanoma was detected in 45 patients (41%) and 36 (33%) died of melanoma. In 11 asymptomatic patients (10%) occult disease was detected with a single PET/CT. In seven of these patients (64%), positive PET/CT finding had major influence in treatment decisions. Four patients underwent surgical metastasectomy and two of them remained disease-free. In 34 patients (31%) PET/CT revealed no disease, but recurrence was detected at a median time of 19 months after negative PET/CT scan. In 50 patients (45%) PET/CT finding was true negative. In 15 patients (14%) scan was false positive leading to additional management or repetitive imagings.
  
  
  CONCLUSIONS
  A single PET/CT could detect 24% of all recurrences in asymptomatic melanoma patients at the early stage of follow-up, but an earlier detection of occult metastases did not improve survival.
authors.affiliation: a Department of Plastic and General Surgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: I
authors.initials: I
authors.lastname: Koskivuo
authors.affiliation: b Turku PET Centre, Turku University Hospital and University of Turku , Turku , Finland.|c Department of Clinical Physiology and Nuclear Medicine , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: J
authors.initials: J
authors.lastname: Kemppainen
authors.affiliation: a Department of Plastic and General Surgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: S
authors.initials: S
authors.lastname: Giordano
authors.affiliation: b Turku PET Centre, Turku University Hospital and University of Turku , Turku , Finland.|c Department of Clinical Physiology and Nuclear Medicine , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: M
authors.initials: M
authors.lastname: Seppänen
authors.affiliation: a Department of Plastic and General Surgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: E
authors.initials: E
authors.lastname: Veräjänkorva
authors.affiliation: d Department of Oncology , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: P
authors.initials: P
authors.lastname: Vihinen
authors.affiliation: d Department of Oncology , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: H
authors.initials: H
authors.lastname: Minn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012878:Skin Neoplasms; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18