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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2005

01-11-2005 | Original Articles

Melanoma Metastases in Regional Lymph Nodes Are Accurately Detected by Proton Magnetic Resonance Spectroscopy of Fine-Needle Aspirate Biopsy Samples

Authors: Jonathan R. Stretch, DPhil, FRACS, Ray Somorjai, PhD, Roger Bourne, PhD, Edward Hsiao, MD, Richard A. Scolyer, FRCPA, Brion Dolenko, MSc, John F. Thompson, MD, FRACS, Carolyn E. Mountford, DPhil, Cynthia L. Lean, PhD

Published in: Annals of Surgical Oncology | Issue 11/2005

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Abstract

Background

Nonsurgical assessment of sentinel nodes (SNs) would offer advantages over surgical SN excision by reducing morbidity and costs. Proton magnetic resonance spectroscopy (MRS) of fine-needle aspirate biopsy (FNAB) specimens identifies melanoma lymph node metastases. This study was undertaken to determine the accuracy of the MRS method and thereby establish a basis for the future development of a nonsurgical technique for assessing SNs.

Methods

FNAB samples were obtained from 118 biopsy specimens from 77 patients during SN biopsy and regional lymphadenectomy. The specimens were histologically evaluated and correlated with MRS data. Histopathologic analysis established that 56 specimens contained metastatic melanoma and that 62 specimens were benign. A linear discriminant analysis–based classifier was developed for benign tissues and metastases.

Results

The presence of metastatic melanoma in lymph nodes was predicted with a sensitivity of 92.9%, a specificity of 90.3%, and an accuracy of 91.5% in a primary data set. In a second data set that used FNAB samples separate from the original tissue samples, melanoma metastases were predicted with a sensitivity of 87.5%, a specificity of 90.3%, and an accuracy of 89.1%, thus supporting the reproducibility of the method.

Conclusions

Proton MRS of FNAB samples may provide a robust and accurate diagnosis of metastatic disease in the regional lymph nodes of melanoma patients. These data indicate the potential for SN staging of melanoma without surgical biopsy and histopathological evaluation.
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Metadata
Title
Melanoma Metastases in Regional Lymph Nodes Are Accurately Detected by Proton Magnetic Resonance Spectroscopy of Fine-Needle Aspirate Biopsy Samples
Authors
Jonathan R. Stretch, DPhil, FRACS
Ray Somorjai, PhD
Roger Bourne, PhD
Edward Hsiao, MD
Richard A. Scolyer, FRCPA
Brion Dolenko, MSc
John F. Thompson, MD, FRACS
Carolyn E. Mountford, DPhil
Cynthia L. Lean, PhD
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2005.03.073

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