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Positron Emission Tomography Appears Superior for Detecting Disease Spread From Malignant Melanoma: Presented at ESMO
By Charlene Laino
VIENNA, AUSTRIA --- November 4, 2004 --- Positron emission tomography (PET) is superior to computed tomography (CT) in detecting both regional lymph node disease and metastatic disease in patients with cutaneous malignant melanoma, a retrospective study shows.
Marta Santisteban, MD, a clinical oncologist at Clínica Universitaria de Navarra in Pamplona, Spain, presented the findings here on November 1st at the 29th European Society for Medical Oncology.
The researchers studied 144 patients with a mean age of 45 years. All had histological confirmed cutaneous malignant melanoma; the primary site was the extremities in 51% of patients; the trunk in 31%, and the head and neck in 10%. In the other patients, the primary site was unknown.
All the patients underwent both 18-fluoro-2-deoxy-D-glucose positron emission tomography (18FDG-PET) and computed tomography; the maximum interval between the 2 scans was 5 weeks.
Statistical analysis using the McNemar test showed that PET had a sensitivity of 93% in detecting regional node disease, while CT had a sensitivity of 66% (P <.0001), Dr. Santisteban reported.
Also, comparisons using the Chi test showed PET to have a better negative predictive value in detecting metastatic disease: 95% versus 85% for CT (P =.05), she said.
Most importantly, "in 18% of patients, PET changed the clinical management," Dr. Santisteban said in an interview. "In 4% of patients, PET saw regional disease that was not spotted on CT, in 6% of patients PET saw [previously undetected] metastatic disease, and in 8%, PET saw [previously undetected] distant metastatic disease."
She recommended that clinicians schedule all patients with stage III cutaneous malignant melanoma for PET scans. Some patients with stage IV disease are also candidates, she added, although the disease can be so far advanced that an improved scan would not change the course of treatment.
[Presentation title: Positron Emission Tomography is Superior to Computed Tomography for Regional Nodes Disease and Metastatic Detection in Cutaneous Malignant Melanoma Patients. Abstract 776P]
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