Abstract
Objective:We investigated the utility of PET/CT in cutaneous melanoma (CM) patients with pathological negative sentinel lymph nodes (SLN), within the first year.Methods:The results of PET/CTs and SLN biopsy (SLNB) in 65 patients (39 male and 26 female, mean age 53.8) with a PET/CT in the first postoperative year were evaluated. Within this cohort, the utility of early PET/CT imaging was assessed in patients with negative SLNB. McNemar test was used to compare PET/CT findings with SLNB results.Results:Out of 43 patients with pathologically positive SLNs, 23 patients (53.5%) had positive and 20 patients (46.5%) had negative findings on PET/CT within the first postoperative year. On the other hand, PET/CT results of 22 patients with negative SLNBs were found to be negative in 19 patients (86.4%) and positive in 3 patients (13.6%). For the patients with negative SLNB results, the detection rate of distant metastasis with PET/CT was significantly lower (p<0.001) than that in patients with positive SLNBs.Conclusion:Our results showed that 18F-FDG PET/CT will most likely (86.4%) be negative during the first postoperative year in patients with a negative SLNB. Therefore, it is concluded that this modality would not provide any significant clinical contribution within this time frame.
Highlights
PET/CT is introduced as an important scintigraphic imaging method for both the diagnosis and restaging of maligant diseases as well as the evaluation of treatment outcomes
The existing published articles have focused on the utility of 18F-FDG PET or PET/CT to demonstrate distant metastases in patients with positive SLN biopsy (SLNB), and this imaging method was not recommended at early stages of this disease for this particular purpose
18F-FDG PET/CT performed within the first year after excision of the primary lesion in patients with cutaneous melanoma (CM) was positive in 53.5% of patients with a positive SLNB, and was negative in 86.4% of patients with a negative SLNB
Summary
PET/CT is introduced as an important scintigraphic imaging method for both the diagnosis and restaging of maligant diseases as well as the evaluation of treatment outcomes. It is a valuable method, it is a costly procedure with considerable radiation exposure to tissues. The use of 18F-FDG PET/CT for both staging and followup of patients with cutaneous melanoma (CM), which is a disease that threatens life and spreads with lymphatic metastases, has been previously reviewed by clinicians [1,2,3,4]. PET/ CT has been proven to be useful in the staging of CM, it should only be used in patients when truly indicated. SLNB results might have clues to determine the exact timing of this examination
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