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Meta-analysis of the performance of 18F-FDG PET in cutaneous melanoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Introduction

The aim of this study was to perform a systematic review of the literature to evaluate the accuracy of FDG-PET in staging and restaging of cutaneous melanoma.

Methods

Systematic methods were used to identify, select, and evaluate the methodologic quality of the studies as well as to summarize the overall findings of sensitivity and specificity. The search strategy consisted of identifying studies published between 2000 and 2006. Inclusion criteria were studies that evaluated the diagnostic performance of FDG-PET in staging/restaging of cutaneous melanoma. The results were compared and pooled with a meta-analysis published previously that included studies published until 1999. The meta-analysis included 95% confidence intervals (CI) of sensitivity, specificity, likelihood-ratio (LR), and diagnostic-odds-ratio (DOR).

Results

The quantitative meta-analysis included 24 studies that were analysed in two groups: eight studies were included only in the regional staging analysis (group I), 13 studies were included only in the detection of distant metastases analysis (group II), and three studies were included in both analyses. Compliance with the methodologic-quality criteria was acceptable. We analysed the results of data presented in patients, lesions, basins, lymph-nodes, areas, and scans. Regarding the performance of FDG-PET in the detection of metastases, the pooled studies presented homogeneity for the negative-LR (0.15; 95% CI, 0.10–0.22) when analyzing lesions. When analyzing scans, there was global homogeneity for specificity (0.86; 95% CI, 0.77–0.92), positive-LR (5.86; 95% CI, 3.64–9.43), and DOR (37.89; 95% CI, 15.80–90.86). The pooled studies presented heterogeneity for the other items analysed. Regarding the detection of regional metastases, when analyzing lymph-nodes there was global homogeneity for specificity (0.99; 95% CI, 0.97–0.99; P = 0.101). The meta-regression evidenced that the variable that most influenced the DOR of the different studies and that can explain the heterogeneity was the year of publication; this may be related to the evolution of PET technology and an improvement of sensitivity/specificity.

Conclusion

FDG-PET is not useful in the evaluation of regional metastases, as it does not detect microscopic disease. However, FDG-PET could be useful in the detection of distant metastases, and could suggest its utility in the management of patients with cutaneous melanoma.

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Authors and Affiliations

  1. Nuclear Medicine Department, Hospital General Universitario Gregorio Marañón, C/ Doctor Esquerdo, 46, Madrid, 28007, Spain

    Felisa Jiménez-Requena & José M. Pérez-Vázquez

  2. Nuclear Medicine Department, Hospital Clínico San Carlos, C/ Prof. Martín Lagos S/N, Madrid, 28040, Spain

    Roberto C. Delgado-Bolton & José L. Carreras-Delgado

  3. Research Unit, Hospital Clínico San Carlos, Madrid, Spain

    Cristina Fernández-Pérez

  4. Department of Radiology, James H. Clark Center, Stanford University School of Medicine, Stanford, CA, USA

    Sanjiv S. Gambhir

  5. Department of Molecular & Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Judy Schwimmer

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  1. Felisa Jiménez-Requena
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  2. Roberto C. Delgado-Bolton
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  3. Cristina Fernández-Pérez
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  4. Sanjiv S. Gambhir
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  7. José L. Carreras-Delgado
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Corresponding author

Correspondence to Roberto C. Delgado-Bolton.

Additional information

Jiménez-Requena and Delgado-Bolton have contributed equally to this work.

The first author is currently a 4th-year resident of Nuclear Medicine in the Hospital General Universitario Gregorio Marañón, Madrid, Spain.

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Jiménez-Requena, F., Delgado-Bolton, R.C., Fernández-Pérez, C. et al. Meta-analysis of the performance of 18F-FDG PET in cutaneous melanoma. Eur J Nucl Med Mol Imaging 37, 284–300 (2010). https://doi.org/10.1007/s00259-009-1224-8

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  • DOI: https://doi.org/10.1007/s00259-009-1224-8

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