Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2006

01-04-2006

Utility of Preoperative [(18)]F Fluorodeoxyglucose–Positron Emission Tomography Scanning in High-Risk Melanoma Patients

Authors: Mary S. Brady, MD, FACS, Timothy Akhurst, MD, Kathryn Spanknebel, MD, Susan Hilton, MD, Mithat Gonen, PhD, Ami Patel, BA, Steven Larson, MD

Published in: Annals of Surgical Oncology | Issue 4/2006

Login to get access

Abstract

Background

[(18)]F Fluorodeoxyglucose-positron emission tomography (PET) scanning provides functional imaging based on glucose uptake by tumors. Melanoma is a glucose-avid malignancy, and preoperative PET scanning in melanoma patients has the potential to guide appropriate treatment.

Methods

We performed a prospective trial to evaluate the clinical utility of whole-body fluorine 18–labeled deoxyglucose-PET scanning used in addition to standard imaging (contrast-enhanced computed tomographic [CT] imaging of the chest, abdomen, and pelvis) in preoperative stage IIC (T4N0M0), III (any T, N1 to N3, M0), and IV (any T, any N, M1) melanoma patients. Pathologic or clinical follow-up within 4 to 6 months of the imaging studies was used to determine the accuracy of preoperative PET and CT scan findings.

Results

Preoperative imaging findings led to a change in clinical management in 36 (35%) of 103 patients. In 32 (89%) of these patients, the information was accurate. Findings on PET scan alone (14 of 36; 39%) or in combination with CT (20 of 36; 56%) resulted in a treatment change in most patients (34 of 36; 94%). The most common decision was to cancel the operation (19 of 36; 53%). PET scanning was more sensitive than CT scanning in detecting occult disease (68% vs. 48%; P = .05), but both tests were highly specific (92% vs. 95%; P = .7, PET vs. CT).

Conclusions

PET scanning facilitates the appropriate management of high-risk melanoma patients being considered for operative intervention. PET imaging in addition to CT scanning should be strongly considered before operation in patients at high risk for occult metastatic disease.
Literature
1.
2.
Damian DL, Fulham MJ, Thompson E, Thompson JF. Positron emission tomography in the detection and management of metastatic melanoma. Melanoma Res 1996;6:325–9PubMed
3.
Holder WD Jr, White RL Jr, Zuger JH, Easton EJ Jr, Greene FL. Effectiveness of positron emission tomography for the detection of melanoma metastases. Ann Surg 1998;227:764–9CrossRefPubMed
4.
Macfarlane DJ, Sondak V, Johnson T, Wahl RL. Prospective evaluation of 2-[18F]-2-deoxy-d-glucose positron emission tomography in staging of regional lymph nodes in patients with cutaneous malignant melanoma. J Clin Oncol 1998;16:1770–6PubMed
5.
Rinne D, Baum RP, Hor G, Kaufmann R. Primary staging and follow-up of high risk melanoma patients with whole-body 18F-fluorodeoxyglucose positron emission tomography: results of a prospective study of 100 patients. Cancer 1998;82:1664–71CrossRefPubMed
6.
Finkelstein SE, Carrasquillo JA, Hoffman JM, et al. A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy. Ann Surg Oncol 2004;11:731–8CrossRefPubMed
7.
Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001;19:3635–48PubMed
8.
McNemar Q. A note on the sampling error of the difference between correlated proportions or percentages. Psychometrika 1979;12:153–7
9.
Gritters LS, Francis IR, Zasadny KR, Wahl RL. Initial assessment of positron emission tomography using 2-fluorine-18-fluoro-2-deoxy-d-glucose in the imaging of malignant melanoma. J Nucl Med 1993;34:1420–7PubMed
10.
Nguyen AT, Akhurst T, Larson SM, Coit DG, Brady MS. PET scanning with (18)F 2-fluoro-2-deoxy-d-glucose (FDG) in patients with melanoma. Benefits and limitations. Clin Positron Imaging 1999;2:93–8PubMed
11.
Swetter SM, Carroll LA, Johnson DL, Segall GM. Positron emission tomography is superior to computed tomography for metastatic detection in melanoma patients. Ann Surg Oncol 2002;9:646–53CrossRefPubMed
12.
Stas M, Stroobants S, Dupont P, et al. 18-FDG PET scan in the staging of recurrent melanoma: additional value and therapeutic impact. Melanoma Res 2002;12:479–90CrossRefPubMed
13.
Wagner JD, Schauwecker D, Davidson D, et al. Prospective study of fluorodeoxyglucose-positron emission tomography imaging of lymph node basins in melanoma patients undergoing sentinel node biopsy. J Clin Oncol 1999;17:1508–15PubMed
14.
Wagner JD, Schauwecker D, Davidson D, et al. Inefficacy of F-18 fluorodeoxy-d-glucose-positron emission tomography scans for initial evaluation in early-stage cutaneous melanoma. Cancer 2005;104:570–9CrossRefPubMed
15.
Tyler DS, Onaitis M, Kherani A, et al. Positron emission tomography scanning in malignant melanoma. Cancer 2000;89:1019–25CrossRefPubMed
Metadata
Title
Utility of Preoperative [(18)]F Fluorodeoxyglucose–Positron Emission Tomography Scanning in High-Risk Melanoma Patients
Authors
Mary S. Brady, MD, FACS
Timothy Akhurst, MD
Kathryn Spanknebel, MD
Susan Hilton, MD
Mithat Gonen, PhD
Ami Patel, BA
Steven Larson, MD
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.02.008

Other articles of this Issue 4/2006

Annals of Surgical Oncology 4/2006 Go to the issue

OriginalPaper

Significance of Papillary Lesions at Percutaneous Breast Biopsy

OriginalPaper

Improved Outcome With Cytoreduction Versus Embolization for Symptomatic Hepatic Metastases of Carcinoid and Neuroendocrine Tumors

Editorial

Fluorodeoxyglucose Positron Emission Tomography for Melanoma Staging: Refining the Indications

Editorial

Knowing When Not to Operate on Cancer: The Essence of Surgical Oncology and the Challenge for the Mentor

OriginalPaper

Long-Term Results of Two Prospective Trials of Preoperative External Beam Radiotherapy for Localized Intermediate- or High-Grade Retroperitoneal Soft Tissue Sarcoma

OriginalPaper

Surgical Complications Associated With Sentinel Lymph Node Biopsy: Results From a Prospective International Cooperative Group Trial