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Titolo:
Positron emission tomography scanning in malignant melanoma - Clinical utility in patients with Stage III disease
Autore:
Tyler, DS; Onaitis, M; Kherani, A; Hata, A; Nicholson, E; Keogan, M; Fisher, S; Coleman, E; Seigler, HF;
Indirizzi:
Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA Duke Univ Durham NC USA 27710 v, Med Ctr, Dept Surg, Durham, NC 27710 USA Duke Univ, Med Ctr, Dept Radiol, Durham, NC 27710 USA Duke Univ Durham NCUSA 27710 Med Ctr, Dept Radiol, Durham, NC 27710 USA
Titolo Testata:
CANCER
fascicolo: 5, volume: 89, anno: 2000,
pagine: 1019 - 1025
SICI:
0008-543X(20000901)89:5<1019:PETSIM>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
COMPUTED-TOMOGRAPHY; METASTATIC MELANOMA; INITIAL ASSESSMENT; PET; 2-FLUORINE-18-FLUORO-2-DEOXY-D-GLUCOSE; 2--FLUORO-2-DEOXY-D-GLUCOSE; ONCOLOGY; CANCER; NODES;
Keywords:
melanoma; positron emission tomography (PET) scan; 2-fluorine-18; 2-fluoro-2-deoxy-D-glucose (FDG); in-transit disease; metastatic;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Tyler, DS Duke Univ, Med Ctr, Dept Surg, Box 3118, Durham, NC 27710 USA Duke Univ Box 3118 Durham NC USA 27710 118, Durham, NC 27710 USA
Citazione:
D.S. Tyler et al., "Positron emission tomography scanning in malignant melanoma - Clinical utility in patients with Stage III disease", CANCER, 89(5), 2000, pp. 1019-1025

Abstract

BACKGROUND. Several recent studies have demonstrated the low yield of anatomically based computed tomography scans in evaluating Stage III (American Joint Committee on Cancer) patients with malignant melanoma. The purpose ofthis theMETHODS. A prospective evaluation of 106 whole body PET scans obtained after injection of 2-fluorine-18, 2-fluoro-2-deoxy-D-glucose (FDG) was performed in 95 study was to investigate the efficacy and clinical utility of functionally based positron emission tomography (PET) scans in the same patientpopulation. patients with clinically evident Stage III lymph node and/or in-transit melanoma. Areas of abnormality on FDG PET scanning were identified visually as foci of increased metabolic activity compared with background, and all positive foci were assessed pathologically. RESULTS. In this patient population, there were 234 areas that were evaluated pathologically of which 165 were confirmed histologically to be melanoma. PET scanning identified 144 of the 165 areas of melanoma for a sensitivity of 87.3%. The 21 areas of melanoma that were missed included 10 microscopic foci, 9 foci less than 1 cm, and 2 foci greater than 1 cm. There were 39 areas of increased PET activity that were not associated with malignancy for a 78.6% predictive value of a positive test. Of the 39 false-positive areas (false-positive rate of 56.5%), 13 could be attributed to recent surgery, 3 to arthritis, 3 to infection, 2 to superficial phlebitis, 1 to a benign skin nevus, and 1 to a colonic polyp. Pathologic evaluation of the remaining false-positive areas failed to reveal a definitive etiology for their increased activity on PET scan. With the application of pertinent clinical information, the predictive Value of a positive PET scan could be improved to 90.6%, The specificity of PET scanning in this study was only 43.5% because very few prophylactic lymph node dissections were performed. Thirty-sixof the total 183 abnormal areas (19.7%) on PET scanning proved to be unsuspected areas of metastatic disease. These findings led to a change in the planned clinical management in patients after 16 of the 106 PET scans (15.1%). CONCLUSIONS. FDG PET scanning can be helpful in managing patients with Stage III melanoma in whom further surgery is contemplated. Although false-positive areas are not uncommon, PET scans did change the management of patients 15% of the time. PET's inability to identify microscopic disease suggests that it is of limited use in evaluating patients with Stage I-II disease. (C) 2000 American Cancer Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/10/20 alle ore 22:10:27