Patrick Veit MD, Presenter: Nothing to Disclose

Florian Matthias Vogt MD, Abstract Co-Author: Nothing to Disclose

Robert Jablonka MD, Abstract Co-Author: Nothing to Disclose

Andreas Gutzeit MD, Abstract Co-Author: Nothing to Disclose

Hilmar Kuehl MD, Abstract Co-Author: Nothing to Disclose

Gerald Antoch MD, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of whole-body PET/CT for staging of newly diagnosed melanoma

28 newly diagnosed consecutive patients underwent whole-body [18F]-2-Fluoro-2-deoxy-D-glucose (FDG) PET/CT for staging after resection of the primary tumor. The CT images were evaluated by two radiologists, the PET images by two nuclear physicians. Side-by-side CT + PET data as well as fused PET/CT images were assessed by one radiologist and one nuclear physician in consensus. Histology and a mean clinical follow-up of 12 months served as the standards of reference. Differences between the imaging procedures were tested for statistical significance by McNemar’s test

The overall TNM stage was correctly determined in 23/28 cases with PET/CT (82%), in 22/28 cases with PET and CT + PET (79%, p>0,05) and in 19/28 (68%) patients with CT alone (p>0,05). N-stage was correctly determined in 34/34 lymph nodes (100%) with PET/CT, in 28/34 (82%) with CT alone (p0,05) with PET and CT + PET. M-stage showed 28/28 correctly determined metastases (100%) on PET/CT, 27/28 (96%) metastases on CT and CT + PET (p>0,05) and 26/28 (92%) metastases on PET alone (p>0,05). Due to prior resection of the primary tumor, histopathology of all primary tumor sites was available, but T-stage was not assessed separately. There were 3 cases where only fused PET/CT was able to exactly localize distant metastases or single lymph nodes, while the other imaging modalities failed to reveal the exact localisation. This was found to be helpful in surgical planning and exact intraoperative resection.

Dual-modality PET/CT can accurately define the location of a metastasis which may be of benefit in patients undergoing surgery. However, differences in staging results of PET/CT, PET, and CT + PET did not prove to be statistically significant, thus any of the three may be recommended in melanoma patients.

Veit, P, Vogt, F, Jablonka, R, Gutzeit, A, Kuehl, H, Antoch, G, Whole-Body PET/CT in Staging of Newly Diagnosed Malignant Melanoma: Initial Results.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415718.html