Skip to main content
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 9/2007

01.09.2007 | Original article

Direct comparison of [18F]FDG PET/CT with PET alone and with side-by-side PET and CT in patients with malignant melanoma

verfasst von: Felix M. Mottaghy, Cord Sunderkötter, Roland Schubert, Petra Wohlfart, Norbert M. Blumstein, Bernd Neumaier, Gerhard Glatting, Cueneyt Özdemir, Andreas K. Buck, Karin Scharfetter-Kochanek, Sven N. Reske

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 9/2007

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this retrospective, blinded study was to evaluate the additional value of [18F]FDG PET/CT in comparison with PET alone and with side-by-side PET and CT in patients with malignant melanoma (MM).

Methods

A total of 127 consecutive studies of patients with known MM referred for a whole-body PET/CT examination were included in this study. PET alone, side-by-side PET and CT and integrated PET/CT study were independently and separately interpreted without awareness of the clinical information. One score each was applied for certainty of lesion localisation and for certainty of lesion characterisation. Verification of the findings was subsequently performed using all available clinical, pathological (n = 30) and follow-up information.

Results

The number of lesions with an uncertain localisation was significantly (p < 0.001) reduced by PET/CT and side-by-side PET and CT (p < 0.05) in comparison with PET alone. In line with this increase in certainty integrated PET/CT reading also improved certainty in characterisation of lesions, however, this did not reach significance (p = 0.057) compared versus PET alone. Respectively, PET, side-by-side PET and CT and PET/CT showed a sensitivity of 86%, 89% and 91%, a specificity of 94%, 94% and 94%, a positive predictive value of 96%, 96% and 96% and a negative predictive value of 80%, 83% and 87%.

Conclusion

Integrated PET/CT offers a significant benefit in lesion localisation and an improvement in lesion characterisation compared with PET alone or with side-by-side PET and CT. The benefit is not as great as that reported for other tumour entities, which may be due to the high avidity of MM for [18F]FDG.
Literatur
1.
Zurück zum Zitat Garbe C, Paul A, Kohler-Spath H, Ellwanger U, Stroebel W, Schwarz M, et al. Prospective evaluation of a follow-up schedule in cutaneous melanoma patients: recommendations for an effective follow-up strategy. J Clin Oncol 2003;21:520–9.PubMedCrossRef Garbe C, Paul A, Kohler-Spath H, Ellwanger U, Stroebel W, Schwarz M, et al. Prospective evaluation of a follow-up schedule in cutaneous melanoma patients: recommendations for an effective follow-up strategy. J Clin Oncol 2003;21:520–9.PubMedCrossRef
2.
Zurück zum Zitat Morton DL, Wanek L, Nizze JA, Elashoff RM, Wong JH. Improved long-term survival after lymphadenectomy of melanoma metastatic to regional nodes. Analysis of prognostic factors in 1134 patients from the John Wayne Cancer Clinic. Ann Surg 1991;214:491–9.PubMedCrossRef Morton DL, Wanek L, Nizze JA, Elashoff RM, Wong JH. Improved long-term survival after lymphadenectomy of melanoma metastatic to regional nodes. Analysis of prognostic factors in 1134 patients from the John Wayne Cancer Clinic. Ann Surg 1991;214:491–9.PubMedCrossRef
3.
Zurück zum Zitat Wood TF, DiFronzo LA, Rose DM, Haigh PI, Stern SL, Wanek L, et al. Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival? Ann Surg Oncol 2001;8:658–62.PubMedCrossRef Wood TF, DiFronzo LA, Rose DM, Haigh PI, Stern SL, Wanek L, et al. Does complete resection of melanoma metastatic to solid intra-abdominal organs improve survival? Ann Surg Oncol 2001;8:658–62.PubMedCrossRef
4.
Zurück zum Zitat Ollila DW, Hsueh EC, Stern SL, Morton DL. Metastasectomy for recurrent stage IV melanoma. J Surg Oncol 1999;71:209–13.PubMedCrossRef Ollila DW, Hsueh EC, Stern SL, Morton DL. Metastasectomy for recurrent stage IV melanoma. J Surg Oncol 1999;71:209–13.PubMedCrossRef
5.
Zurück zum Zitat Balch CM, Buzaid AC, Soong SJ, Atkins MB, Cascinelli N, Coit DG, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001;19:3635–48.PubMed Balch CM, Buzaid AC, Soong SJ, Atkins MB, Cascinelli N, Coit DG, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001;19:3635–48.PubMed
6.
Zurück zum Zitat Stephens PL, Ariyan S, Ocampo RV, Poo WJ. The predictive value of lymphoscintigraphy for nodal metastases of cutaneous melanoma. Conn Med 1999;63:387–90.PubMed Stephens PL, Ariyan S, Ocampo RV, Poo WJ. The predictive value of lymphoscintigraphy for nodal metastases of cutaneous melanoma. Conn Med 1999;63:387–90.PubMed
7.
Zurück zum Zitat Dicker TJ, Kavanagh GM, Herd RM, Ahmad T, McLaren KM, Chetty U, et al. A rational approach to melanoma follow-up in patients with primary cutaneous melanoma. Scottish Melanoma Group. Br J Dermatol 1999;140:249–54.PubMedCrossRef Dicker TJ, Kavanagh GM, Herd RM, Ahmad T, McLaren KM, Chetty U, et al. A rational approach to melanoma follow-up in patients with primary cutaneous melanoma. Scottish Melanoma Group. Br J Dermatol 1999;140:249–54.PubMedCrossRef
8.
Zurück zum Zitat Rinne D, Baum RP, Hör G, Kaufmann R. Primary staging and follow-up of high risk melanoma patients with whole-body 18F-fluorodeoxyglucose positron emission tomography: results of a prospective study of 100 patients. Cancer 1998;82:1664–71.PubMedCrossRef Rinne D, Baum RP, Hör G, Kaufmann R. Primary staging and follow-up of high risk melanoma patients with whole-body 18F-fluorodeoxyglucose positron emission tomography: results of a prospective study of 100 patients. Cancer 1998;82:1664–71.PubMedCrossRef
9.
Zurück zum Zitat Holder WD Jr, White RL Jr, Zuger JH, Easton EJ Jr, Greene FL. Effectiveness of positron emission tomography for the detection of melanoma metastases. Ann Surg 1998;227:764–9; discussion 769–71.PubMedCrossRef Holder WD Jr, White RL Jr, Zuger JH, Easton EJ Jr, Greene FL. Effectiveness of positron emission tomography for the detection of melanoma metastases. Ann Surg 1998;227:764–9; discussion 769–71.PubMedCrossRef
10.
Zurück zum Zitat Eigtved A, Andersson AP, Dahlstrom K, Rabol A, Jensen M, Holm S, et al. Use of fluorine-18 fluorodeoxyglucose positron emission tomography in the detection of silent metastases from malignant melanoma. Eur J Nucl Med 2000;27:70–5.PubMedCrossRef Eigtved A, Andersson AP, Dahlstrom K, Rabol A, Jensen M, Holm S, et al. Use of fluorine-18 fluorodeoxyglucose positron emission tomography in the detection of silent metastases from malignant melanoma. Eur J Nucl Med 2000;27:70–5.PubMedCrossRef
11.
Zurück zum Zitat Swetter SM, Carroll L, Johnson D, Segall G. Positron emission tomography (PET) is superior to computerized tomography (CT) for metastatic staging in melanoma patients. Clin Positron Imaging 2000;3:154.PubMedCrossRef Swetter SM, Carroll L, Johnson D, Segall G. Positron emission tomography (PET) is superior to computerized tomography (CT) for metastatic staging in melanoma patients. Clin Positron Imaging 2000;3:154.PubMedCrossRef
12.
Zurück zum Zitat Swetter SM, Carroll LA, Johnson DL, Segall GM. Positron emission tomography is superior to computed tomography for metastatic detection in melanoma patients. Ann Surg Oncol 2002;9:646–53.PubMedCrossRef Swetter SM, Carroll LA, Johnson DL, Segall GM. Positron emission tomography is superior to computed tomography for metastatic detection in melanoma patients. Ann Surg Oncol 2002;9:646–53.PubMedCrossRef
13.
Zurück zum Zitat Harris MT, Berlangieri SU, Cebon JS, Davis ID, Scott AM. Impact of 2-deoxy-2[F-18]fluoro-D-glucose positron emission tomography on the management of patients with advanced melanoma. Mol Imaging Biol 2005;23:1–5. Harris MT, Berlangieri SU, Cebon JS, Davis ID, Scott AM. Impact of 2-deoxy-2[F-18]fluoro-D-glucose positron emission tomography on the management of patients with advanced melanoma. Mol Imaging Biol 2005;23:1–5.
14.
Zurück zum Zitat Reinhardt MJ, Joe AY, Jaeger U, Huber A, Matthies A, Bucerius J, et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol 2006;24:1178–87.PubMedCrossRef Reinhardt MJ, Joe AY, Jaeger U, Huber A, Matthies A, Bucerius J, et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol 2006;24:1178–87.PubMedCrossRef
15.
Zurück zum Zitat Mijnhout GS, Hoekstra OS, van Lingen A, van Diest PJ, Ader HJ, Lammertsma AA, et al. How morphometric analysis of metastatic load predicts the (un)usefulness of PET scanning: the case of lymph node staging in melanoma. J Clin Pathol 2003;56:283–6.PubMedCrossRef Mijnhout GS, Hoekstra OS, van Lingen A, van Diest PJ, Ader HJ, Lammertsma AA, et al. How morphometric analysis of metastatic load predicts the (un)usefulness of PET scanning: the case of lymph node staging in melanoma. J Clin Pathol 2003;56:283–6.PubMedCrossRef
16.
Zurück zum Zitat Fink AM, Holle-Robatsch S, Herzog N, Mirzaei S, Rappersberger K, Lilgenau N, et al. Positron emission tomography is not useful in detecting metastasis in the sentinel lymph node in patients with primary malignant melanoma stage I and II. Melanoma Res 2004;14:141–5.PubMedCrossRef Fink AM, Holle-Robatsch S, Herzog N, Mirzaei S, Rappersberger K, Lilgenau N, et al. Positron emission tomography is not useful in detecting metastasis in the sentinel lymph node in patients with primary malignant melanoma stage I and II. Melanoma Res 2004;14:141–5.PubMedCrossRef
17.
Zurück zum Zitat Schäfer A, Herbst RA, Beiteke U, Lange-Ionescu S, Treckmann H, Lohlein D, et al. [Sentinel lymph node excision (SLNE) and positron emission tomography in the staging of stage I–II melanoma patients]. Hautarzt 2003;54:440–7.PubMed Schäfer A, Herbst RA, Beiteke U, Lange-Ionescu S, Treckmann H, Lohlein D, et al. [Sentinel lymph node excision (SLNE) and positron emission tomography in the staging of stage I–II melanoma patients]. Hautarzt 2003;54:440–7.PubMed
18.
Zurück zum Zitat Wagner JD, Schauwecker D, Davidson D, Coleman JJ 3rd, Saxman S, Hutchins G, et al. Prospective study of fluorodeoxyglucose-positron emission tomography imaging of lymph node basins in melanoma patients undergoing sentinel node biopsy. J Clin Oncol 1999;17:1508–15.PubMed Wagner JD, Schauwecker D, Davidson D, Coleman JJ 3rd, Saxman S, Hutchins G, et al. Prospective study of fluorodeoxyglucose-positron emission tomography imaging of lymph node basins in melanoma patients undergoing sentinel node biopsy. J Clin Oncol 1999;17:1508–15.PubMed
19.
Zurück zum Zitat Crippa F, Leutner M, Belli F, Gallino F, Greco M, Pilotti S, et al. Which kinds of lymph node metastases can FDG PET detect? A clinical study in melanoma. J Nucl Med 2000;41:1491–4.PubMed Crippa F, Leutner M, Belli F, Gallino F, Greco M, Pilotti S, et al. Which kinds of lymph node metastases can FDG PET detect? A clinical study in melanoma. J Nucl Med 2000;41:1491–4.PubMed
20.
Zurück zum Zitat Wagner JD, Schauwecker D, Davidson D, Logan T, Coleman JJ 3rd, Hutchins G, et al. Inefficacy of F-18 fluorodeoxy-D-glucose-positron emission tomography scans for initial evaluation in early-stage cutaneous melanoma. Cancer 2005;104:570–9.PubMedCrossRef Wagner JD, Schauwecker D, Davidson D, Logan T, Coleman JJ 3rd, Hutchins G, et al. Inefficacy of F-18 fluorodeoxy-D-glucose-positron emission tomography scans for initial evaluation in early-stage cutaneous melanoma. Cancer 2005;104:570–9.PubMedCrossRef
21.
Zurück zum Zitat Cohade C, Osman M, Leal J, Wahl RL. Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med 2003;44:1797–803.PubMed Cohade C, Osman M, Leal J, Wahl RL. Direct comparison of 18F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med 2003;44:1797–803.PubMed
22.
Zurück zum Zitat Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970;172:902–8.PubMedCrossRef Breslow A. Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma. Ann Surg 1970;172:902–8.PubMedCrossRef
23.
Zurück zum Zitat Berthelsen AK, Holm S, Loft A, Klausen TL, Andersen F, Hojgaard L. PET/CT with intravenous contrast can be used for PET attenuation correction in cancer patients. Eur J Nucl Med Mol Imaging 2005;32:1167–75.PubMedCrossRef Berthelsen AK, Holm S, Loft A, Klausen TL, Andersen F, Hojgaard L. PET/CT with intravenous contrast can be used for PET attenuation correction in cancer patients. Eur J Nucl Med Mol Imaging 2005;32:1167–75.PubMedCrossRef
24.
Zurück zum Zitat Burger C, Goerres G, Schoenes S, Buck A, Lonn AH, Von Schulthess GK. PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients. Eur J Nucl Med Mol Imaging 2002;29:922–7.PubMedCrossRef Burger C, Goerres G, Schoenes S, Buck A, Lonn AH, Von Schulthess GK. PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients. Eur J Nucl Med Mol Imaging 2002;29:922–7.PubMedCrossRef
25.
Zurück zum Zitat Harpio R, Einarsson R. S100 proteins as cancer biomarkers with focus on S100B in malignant melanoma. Clin Biochem 2004;37:512–8.PubMedCrossRef Harpio R, Einarsson R. S100 proteins as cancer biomarkers with focus on S100B in malignant melanoma. Clin Biochem 2004;37:512–8.PubMedCrossRef
26.
Zurück zum Zitat Metz CE, Herman BA, Shen JH. Maximum likelihood estimation of receiver operating characteristic (ROC) curves from continuously-distributed data. Stat Med 1998;17:1033–53.PubMedCrossRef Metz CE, Herman BA, Shen JH. Maximum likelihood estimation of receiver operating characteristic (ROC) curves from continuously-distributed data. Stat Med 1998;17:1033–53.PubMedCrossRef
27.
Zurück zum Zitat Bockisch A, Beyer T, Antoch G, Freudenberg LS, Kuhl H, Debatin JF, et al. Positron emission tomography/computed tomography—imaging protocols, artifacts, and pitfalls. Mol Imaging Biol 2004;6:188–99.PubMedCrossRef Bockisch A, Beyer T, Antoch G, Freudenberg LS, Kuhl H, Debatin JF, et al. Positron emission tomography/computed tomography—imaging protocols, artifacts, and pitfalls. Mol Imaging Biol 2004;6:188–99.PubMedCrossRef
28.
Zurück zum Zitat Gritters LS, Francis IR, Zasadny KR, Wahl RL. Initial assessment of positron emission tomography using 2-fluorine-18-fluoro-2-deoxy-D-glucose in the imaging of malignant melanoma. J Nucl Med 1993;34:1420–7.PubMed Gritters LS, Francis IR, Zasadny KR, Wahl RL. Initial assessment of positron emission tomography using 2-fluorine-18-fluoro-2-deoxy-D-glucose in the imaging of malignant melanoma. J Nucl Med 1993;34:1420–7.PubMed
29.
Zurück zum Zitat Krug B, Dietlein M, Groth W, Stutzer H, Psaras T, Gossmann A, et al. Fluor-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in malignant melanoma. Diagnostic comparison with conventional imaging methods. Acta Radiol 2000;41:446–52.PubMedCrossRef Krug B, Dietlein M, Groth W, Stutzer H, Psaras T, Gossmann A, et al. Fluor-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in malignant melanoma. Diagnostic comparison with conventional imaging methods. Acta Radiol 2000;41:446–52.PubMedCrossRef
30.
Zurück zum Zitat Libberecht K, Husada G, Peeters T, Michiels P, Gys T, Molderez C. Initial staging of malignant melanoma by positron emission tomography and sentinel node biopsy. Acta Chir Belg 2005;105:621–5.PubMed Libberecht K, Husada G, Peeters T, Michiels P, Gys T, Molderez C. Initial staging of malignant melanoma by positron emission tomography and sentinel node biopsy. Acta Chir Belg 2005;105:621–5.PubMed
Metadaten
Titel
Direct comparison of [18F]FDG PET/CT with PET alone and with side-by-side PET and CT in patients with malignant melanoma
verfasst von
Felix M. Mottaghy
Cord Sunderkötter
Roland Schubert
Petra Wohlfart
Norbert M. Blumstein
Bernd Neumaier
Gerhard Glatting
Cueneyt Özdemir
Andreas K. Buck
Karin Scharfetter-Kochanek
Sven N. Reske
Publikationsdatum
01.09.2007
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 9/2007
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-006-0358-1

Weitere Artikel der Ausgabe 9/2007

European Journal of Nuclear Medicine and Molecular Imaging 9/2007 Zur Ausgabe