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2-Deoxy-2-[F-18]fluoro-d-glucose Positron Emission Tomography/Computed Tomography in the Management of Melanoma

  • A. Iagaru
  • A. Quon
  • D. Johnson
  • S. S. Gambhir
  • I. R. McDougallEmail author
Research Article

Abstract

Objectives

2-Deoxy-2-[F-18]fluoro-d-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is widely available as a powerful imaging modality, combining the ability to detect active metabolic processes and their morphologic features in a single exam. The role of FDG-PET is proven in a variety of cancers, including melanoma, but the estimates of sensitivity and specificity are based in the majority of the published studies on dedicated PET, not PET/CT. Therefore, we were prompted to review our experience with FDG-PET/CT in the management of melanoma.

Methods

This is a retrospective study on 106 patients with melanoma (20–87 years old; average: 56.8 ± 15.9), who had whole-body FDG-PET/CT at our institution from January 2003 to June 2005. Thirty-eight patients (35.9%) were women and 68 patients (64.1%) were men. Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed.

Results

All patients had the study for disease restaging. The primary tumor depth (Breslow’s thickness) at initial diagnosis was available for 76 patients (71.7%) and ranged from 0.4 to 25 mm (average: 3.56 mm). The anatomic level of invasion in the skin (Clark’s level) was determined for 70 patients (66%): 3, level II; 13, level III; 43, level IV; 11, level V. The administered dose of 18F FDG ranged from 9.8 to 21.6 mCi (average: 15.4 ± 1.8 mCi). FDG-PET/CT had a sensitivity of 89.3% [95% confidence interval (CI): 78.5–95] and a specificity of 88% (95% CI: 76.2–94.4) for melanoma detection.

Conclusion

This study confirms the good results of FDG-PET/CT for residual/recurrent melanoma detection, as well as for distant metastases localization. PET/CT should be an integral part in evaluation of patients with high-risk melanoma, prior to selection of the most appropriate therapy.

Key words

Melanoma FDG PET/CT 

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Copyright information

© Academy of Molecular Imaging 2006

Authors and Affiliations

  • A. Iagaru
    • 1
  • A. Quon
    • 1
  • D. Johnson
    • 2
  • S. S. Gambhir
    • 3
  • I. R. McDougall
    • 1
    • 4
    Email author
  1. 1.Division of Nuclear Medicine, Department of RadiologyStanford Hospital and ClinicsStanfordUSA
  2. 2.Department of SurgeryStanford Hospital and ClinicsStanfordUSA
  3. 3.Division of Nuclear Medicine, Departments of Radiology and BioengineeringStanford Hospital and ClinicsStanfordUSA
  4. 4.Division of Nuclear MedicineStanford University School of MedicineStanfordUSA

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