PET/CT in the management of patients with stage IIIC and IV metastatic melanoma considered candidates for surgery: Evaluation of the additive value after conventional imaging

Yulia Bronstein, Chaan S. Ng, Eric Rohren, Merrick I. Ross, Jeffrey E. Lee, Janice Cormier, Valen E. Johnson, Wen Jen Hwu

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

OBJECTIVE. The purpose of this article is to determine how often unexpected 18F-FDG PET/CT findings result in a change in management for patients with stage IV and clinically evident stage III melanoma with resectable disease according to conventional imaging. SUBJECTS and met hods. Thirty-two patients with oligometastatic stage IV and clinically evident stage III melanoma were identified by surgical oncologists according to the results of conventional imaging, which included contrast-enhanced CT of the chest, abdomen, and pelvis and MRI of the brain. The surgical plan included resection of known metastases or isolated limb perfusion with chemotherapy. Thirty-three FDG PET/CT scans were performed within 36 days of their contrast-enhanced CT. The impact of PET/CT was defined as the percentage of cases in which a change in the surgical plan resulted from the unanticipated PET/CT findings. RESULTS. PET/CT revealed unexpected melanoma metastases in 12% of scans (4/33). As a result, the surgery was canceled for two patients, and the planned approach was altered for another two patients to address the unexpected sites. In 6% of scans (2/33), the unexpected metastases were detected in the extremities, which were not included in conventional imaging. Three scans (9%) showed false-positive FDG-avid findings that proved to be benign by subsequent stability or resolution with no therapy. CONCLUSION. In patients with surgically treatable metastatic melanoma, FDG PET/ CT can detect unexpected metastases that are missed or not imaged with conventional imaging, and can be considered as part of preoperative workup.

Original languageEnglish (US)
Pages (from-to)902-908
Number of pages7
JournalAmerican Journal of Roentgenology
Volume198
Issue number4
DOIs
StatePublished - Apr 2012

Keywords

  • Additive value
  • FDG PET
  • Imaging
  • Melanoma
  • PET/CT

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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