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Prospective comparison of [18F]fluorodeoxyglucose positron emission tomography and computed tomography in patients with melanoma with palpable lymph node metastases: diagnostic accuracy and impact on treatment.
J Clin Oncol. 2009 Oct 01; 27(28):4774-80.JC

Abstract

PURPOSE

Patients with melanoma with potentially resectable lymph node metastases require accurate staging to prevent unnecessary surgery. [(18)F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is attractive for this because melanoma typically is FDG avid. The aim of this prospective multicenter study was to perform a head-to-head comparison of FDG-PET and computed tomography (CT) in staging of patients with melanoma with palpable lymph node metastases in terms of diagnostic accuracy and impact on treatment.

PATIENTS AND METHODS

All consecutive patients with palpable, proven lymph node metastases of melanoma between mid 2003 and 2007 were prospectively included. The number/site of distant metastases detected with FDG-PET and CT were recorded. Histology/cytology or 6 months follow-up were the reference standard. Intended and performed treatment was recorded.

RESULTS

Distant metastases were suspected by FDG-PET in 32% of the 251 patients and by CT in 29% (P = .26). Upstaging was correct in 27% by FDG-PET and in 24% by CT (P = .18). FDG-PET detected more metastatic sites (133 v 112, P = .03), detecting significantly more bone and subcutaneous metastases. Treatment changed in 19% of patients; in 79% as a result of both scans, in 17% exclusively by FDG-PET, and in 4% exclusively by CT. In 34 patients (14%), FDG-PET had an additional value over spiral CT, and in 23 patients (9%), CT had additional value over FDG-PET.

CONCLUSION

As a result of FDG-PET and CT, 27% of patients were upstaged, and treatment changed in one of five patients. FDG-PET and CT are equivalent in upstaging; however, FDG-PET detected more metastatic sites, especially bone and subcutaneous. FDG-PET and/or CT are indicated in the staging of patients with melanoma with palpable lymph node metastases.

Authors+Show Affiliations

Department of Surgical Oncology, University Medical Centre Groningen,9700 RB Groningen, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19720925

Citation

Bastiaannet, Esther, et al. "Prospective Comparison of [18F]fluorodeoxyglucose Positron Emission Tomography and Computed Tomography in Patients With Melanoma With Palpable Lymph Node Metastases: Diagnostic Accuracy and Impact On Treatment." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 27, no. 28, 2009, pp. 4774-80.
Bastiaannet E, Wobbes T, Hoekstra OS, et al. Prospective comparison of [18F]fluorodeoxyglucose positron emission tomography and computed tomography in patients with melanoma with palpable lymph node metastases: diagnostic accuracy and impact on treatment. J Clin Oncol. 2009;27(28):4774-80.
Bastiaannet, E., Wobbes, T., Hoekstra, O. S., van der Jagt, E. J., Brouwers, A. H., Koelemij, R., de Klerk, J. M., Oyen, W. J., Meijer, S., & Hoekstra, H. J. (2009). Prospective comparison of [18F]fluorodeoxyglucose positron emission tomography and computed tomography in patients with melanoma with palpable lymph node metastases: diagnostic accuracy and impact on treatment. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 27(28), 4774-80. https://doi.org/10.1200/JCO.2008.20.1822
Bastiaannet E, et al. Prospective Comparison of [18F]fluorodeoxyglucose Positron Emission Tomography and Computed Tomography in Patients With Melanoma With Palpable Lymph Node Metastases: Diagnostic Accuracy and Impact On Treatment. J Clin Oncol. 2009 Oct 1;27(28):4774-80. PubMed PMID: 19720925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective comparison of [18F]fluorodeoxyglucose positron emission tomography and computed tomography in patients with melanoma with palpable lymph node metastases: diagnostic accuracy and impact on treatment. AU - Bastiaannet,Esther, AU - Wobbes,Theo, AU - Hoekstra,Otto S, AU - van der Jagt,Eric J, AU - Brouwers,Adrienne H, AU - Koelemij,Ron, AU - de Klerk,John M H, AU - Oyen,Wim J G, AU - Meijer,Sybren, AU - Hoekstra,Harald J, Y1 - 2009/08/31/ PY - 2009/9/2/entrez PY - 2009/9/2/pubmed PY - 2009/10/27/medline SP - 4774 EP - 80 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 27 IS - 28 N2 - PURPOSE: Patients with melanoma with potentially resectable lymph node metastases require accurate staging to prevent unnecessary surgery. [(18)F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) is attractive for this because melanoma typically is FDG avid. The aim of this prospective multicenter study was to perform a head-to-head comparison of FDG-PET and computed tomography (CT) in staging of patients with melanoma with palpable lymph node metastases in terms of diagnostic accuracy and impact on treatment. PATIENTS AND METHODS: All consecutive patients with palpable, proven lymph node metastases of melanoma between mid 2003 and 2007 were prospectively included. The number/site of distant metastases detected with FDG-PET and CT were recorded. Histology/cytology or 6 months follow-up were the reference standard. Intended and performed treatment was recorded. RESULTS: Distant metastases were suspected by FDG-PET in 32% of the 251 patients and by CT in 29% (P = .26). Upstaging was correct in 27% by FDG-PET and in 24% by CT (P = .18). FDG-PET detected more metastatic sites (133 v 112, P = .03), detecting significantly more bone and subcutaneous metastases. Treatment changed in 19% of patients; in 79% as a result of both scans, in 17% exclusively by FDG-PET, and in 4% exclusively by CT. In 34 patients (14%), FDG-PET had an additional value over spiral CT, and in 23 patients (9%), CT had additional value over FDG-PET. CONCLUSION: As a result of FDG-PET and CT, 27% of patients were upstaged, and treatment changed in one of five patients. FDG-PET and CT are equivalent in upstaging; however, FDG-PET detected more metastatic sites, especially bone and subcutaneous. FDG-PET and/or CT are indicated in the staging of patients with melanoma with palpable lymph node metastases. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/19720925/Prospective_comparison_of_[18F]fluorodeoxyglucose_positron_emission_tomography_and_computed_tomography_in_patients_with_melanoma_with_palpable_lymph_node_metastases:_diagnostic_accuracy_and_impact_on_treatment_ L2 - https://ascopubs.org/doi/10.1200/JCO.2008.20.1822?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -