Author/Editor		Bohuslavizki, Karl H; Klutmann, Susanne; Neuber, Karsten; Wedler, Juliane; Altenhoff, Juergen; Kroeger, Sabine; Buchert, Ralph; Bleckmann, Christian; Clausen, Malte
Title		Correlation of 18F-FDG-PET and histopathology in patients with malignant melanoma
Translated title		Korelacija 18F-FDG-PET s histopatologijo pri bolnikih z malignim melanomom
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 34, št. 1
Publication year		2000
Volume		str. 1-9
Language		eng
Abstract		Background. Preliminary reports suggest that PET using 18F-FDG may be a valuable diagnostic tool in patients with advanced malignant melanoma. Therefore, the aim of this study was to correlate PET lesions with histological findings in staging of malignant melanoma. Patients and methods. A total of 82 patients with malignant melanoma underwent 107 PET examinations for primary staging or therapy monitoring. After an intravenous injection of 370 MBq18F-FDG whole-body images were acguired on an ECAT EXACT 47 (921) with an axial field-of-view of 16.2 cm (Siemens, CTI). Tumor-suspicious PET findings, results of physical examination, and tumor-suspicious lesions by conventional imaging, i.e. ultrasound, CT, and MRl, were evaluated histologically and correlated with each other on a lesion-by-lesion basis. Results. PET detected 124 lesions with an increased focal tracer uptake. In addition, physical examination and conventional imaging revealed 65 tumor-suspicious lesions. In total, 189 tumorsuspicious lesions were evaluated histologically. 18F-FDG-PET was hue-positive in 115/189 lesions and false-positive in 9/189 lesions. In 21 out of 65 PET-negative lesions, biopsy could not confirm melanoma tissue. In contrast, in 44 out of 65 PET- negative lesions further biopsy revealed malignant melanoma tissue. Sensitivity and specificity of 18F-FDG-PET for the detection of malignant melanoma tissue were 72% and 70%, respectively. Negative and positive predictive values of 18F-FDG-PET imaging were 32% and 93%, respectively. With respect to anatomical localization, two thirds of false negative/positive PET lesions were located in the skin or mucosal area. Conclusions. 18F-FDG-PET is a valuable diagnostic tool in order to prove tumor- suspicious lesions in malignant melanoma. However, for exclusion of skin metastases an accurate physical examination of patients with malignant melanoma by a dermatologist is indispensable. (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Preliminarna poročila kažejo, da bi lahko bil PET z uporabo 18F-FDG pomembno diagnostično orodje pri bolnikih z napredovalim malignim melanomom. Cilj te študije je bil korelirati lezije prikazane s PET z histološkimi najdbami pri zamejevanju malignega melanoma. Bolniki in metode. Pri skupno 82 bolnikih z malignim melanomom smo opravili 107 PET preiskav za primarno zamejitev ali spremljanje terapije. Po intravenozni aplikaciji 370MBq 18F-FDG smo na ECAT EXACT 47 (921) posneli sliko celega telesa z aksialnim vidnim poljem 16.2 cm (siemens CTI). Histološko smo evaluirali na tumor sumljive PET izvide in klinične izvide in jih med seboj korelirali lezijo po lezijo. Rezultati. S PET smo odkrili 124 lezij s povečanim fokalnim privzemom tracerja. Dodatno so klinični pregledi in konvencionalna slikovna diagnostika odkrili 65 za tumor sumljivih lezij. Skupno smo odkrili 189 za tumor sumljivih lezij in jih histološko ocenili. 18F-FDG-PET je bil resnično pozitiven v 115 od 189 lezij in lažno pozitiven v 9. Pri 21 od 65 PET negativnih lezijah biopsija ni mogla potrditi melanomskega tkiva. Nasprotno pa je biopsija v 44 od 65 PET negativnih lezijah potrdila maligni melanom. Občutljivost in specifičnost 18F-FDG-PET pri detekciji malignega melanoma je bila 72 oziroma 70%. Negativne in pozitivne predikcijske vrednosti 18F-FDG-PET so bile 32 oziroma 93%. Glede na lokalizacijo sta bili 2/3 lažno negativnih oziroma pozitivnih lezij v koži in v mukozi. Zaključki. 18F- FDG-PET je dragoceno diagnostično orodje za dokazovanje za tumor sumljivih lezij malignega melanoma. Vsekakor pa je za izključitev kožnih metastaz nenadomestljiv klinični pregled bolnikov z malignim melanomom pri dermatologu. Glede na zelo agresivno zdravljenje napredovalega malignega melanoma lahko 18F-FDG-PET pomaga pri izbiri pravega protokola za posameznega bolnika.
Descriptors		MELANOMA TOMOGRAPHY, EMISSION-COMPUTED DEOXYGLUCOSE FLUORINE NEOPLASM STAGING NEOPLASM METASTASIS