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Melanoma Metastases in Regional Lymph Nodes Are Accurately Detected by Proton Magnetic Resonance Spectroscopy of Fine-Needle Aspirate Biopsy Samples

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Abstract

Background

Nonsurgical assessment of sentinel nodes (SNs) would offer advantages over surgical SN excision by reducing morbidity and costs. Proton magnetic resonance spectroscopy (MRS) of fine-needle aspirate biopsy (FNAB) specimens identifies melanoma lymph node metastases. This study was undertaken to determine the accuracy of the MRS method and thereby establish a basis for the future development of a nonsurgical technique for assessing SNs.

Methods

FNAB samples were obtained from 118 biopsy specimens from 77 patients during SN biopsy and regional lymphadenectomy. The specimens were histologically evaluated and correlated with MRS data. Histopathologic analysis established that 56 specimens contained metastatic melanoma and that 62 specimens were benign. A linear discriminant analysis–based classifier was developed for benign tissues and metastases.

Results

The presence of metastatic melanoma in lymph nodes was predicted with a sensitivity of 92.9%, a specificity of 90.3%, and an accuracy of 91.5% in a primary data set. In a second data set that used FNAB samples separate from the original tissue samples, melanoma metastases were predicted with a sensitivity of 87.5%, a specificity of 90.3%, and an accuracy of 89.1%, thus supporting the reproducibility of the method.

Conclusions

Proton MRS of FNAB samples may provide a robust and accurate diagnosis of metastatic disease in the regional lymph nodes of melanoma patients. These data indicate the potential for SN staging of melanoma without surgical biopsy and histopathological evaluation.

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Acknowledgments

Supported by Australian National Health and Medical Research Council Grant 107226. The authors thank Chitra De Silva and Lawrence Li from the Sydney Melanoma Unit for collection of samples and pathology data. They also thank those at the Institute for Magnetic Resonance Research: Susan Dowd for storing and archiving the specimens and Sinead Doran for invaluable help in preparing this manuscript.

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Authors and Affiliations

  1. Sydney Melanoma Unit and Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, Camperdown, New South Wales, 2050, Australia

    Jonathan R. Stretch DPhil, FRACS & John F. Thompson MD, FRACS

  2. Department of Surgery, University of Sydney, Camperdown, New South Wales , 2006, Australia

    Jonathan R. Stretch DPhil, FRACS & John F. Thompson MD, FRACS

  3. Institute for Biodiagnostics, National Research Council of Canada, 435 Ellice Avenue, Winnipeg, Manitoba, R3B 1Y6, Canada Manitoba Canada

    Ray Somorjai PhD & Brion Dolenko MSc

  4. Institute for Magnetic Resonance Research and Department of Magnetic Resonance in Medicine, University of Sydney, Block 3, Level 3, Royal North Shore Hospital, St. Leonards, New South Wales , 2065, Australia

    Roger Bourne PhD, Edward Hsiao MD, Carolyn E. Mountford DPhil & Cynthia L. Lean PhD

  5. Department of Anatomical Pathology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, 2050, Australia

    Richard A. Scolyer FRCPA

Authors
  1. Jonathan R. Stretch DPhil, FRACS
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  2. Ray Somorjai PhD
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  3. Roger Bourne PhD
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  4. Edward Hsiao MD
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  5. Richard A. Scolyer FRCPA
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  6. Brion Dolenko MSc
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  7. John F. Thompson MD, FRACS
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  8. Carolyn E. Mountford DPhil
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  9. Cynthia L. Lean PhD
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Correspondence to Cynthia L. Lean PhD.

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Stretch, J.R., Somorjai, R., Bourne, R. et al. Melanoma Metastases in Regional Lymph Nodes Are Accurately Detected by Proton Magnetic Resonance Spectroscopy of Fine-Needle Aspirate Biopsy Samples. Ann Surg Oncol 12, 943–949 (2005). https://doi.org/10.1245/ASO.2005.03.073

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  • DOI: https://doi.org/10.1245/ASO.2005.03.073

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