The role of FDG-PET-CT is limited in initial staging of nodal metastasis for thin cutaneous melanoma - 12/04/21
, Christopher F. McNicoll a , Daniel Kirgan a , Maris S. Jones b , Mariangela R. Rivera c , Gabriela M. Doyle a , Margret D. De Guzman a , Jennifer Baynosa a , Charles R. St Hill a, ⁎ Abstract |
Introduction |
Positron emission tomography computed tomography (PET-CT) is often used to stage nodal metastases in thin cutaneous melanoma, with limited evidence.
Methods |
A retrospective review of patients with cutaneous malignant melanoma treated at our institution was performed from 2005 to 2015, identifying those who received a PET-CT prior to lymphadenectomy. Biopsy features, lymph node status, and PET-CT results were collected. We calculated the overall sensitivity, specificity, accuracy, likelihood ratios, and positive predictive value of PET-CT in identifying nodal metastases. Results were stratified by initial biopsy tumor depth.
Results |
We identified 367 cases; 95 obtained a PET-CT prior to lymphadenectomy. Overall, sensitivity and specificity of PET-CT was 34.6% and 95.4%, respectively. The positive likelihood ratio and negative likelihood ratio were 7.62 and 0.68, respectively. The accuracy was 78.2%. The positive predictive value for T3 and T4 melanomas were 100% and 81.4%, respectively. For thin melanomas, specificity and accuracy was 88.2% and 88.2%, respectively.
Conclusions |
PET-CT has low specificity and its use alone is not recommended for initial staging of nodal metastases in thin cutaneous malignant melanoma.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Sensitivity of PET-CT for detection of nodal metastases in all melanomas was 34.6%. |
• | Specificity of PET-CT for detection of nodal metastases in all melanomas was 95.4%. |
• | Calculated positive predictive value of PET-CT in all melanomas was 88.2%. |
• | Specificity of PET-CT for detection of nodal metastases in thin melanomas was 88.2%. |
• | Calculated positive predictive value of PET-CT in thin melanomas was 28.3%. |
Résumé |
In all melanomas, PET-CT has low sensitivity and accuracy for nodal metastases. In thin melanomas, PET-CT has low specificity and accuracy for nodal metastases.
Le texte complet de cet article est disponible en PDF.Keywords : Cutaneous melanoma, Positron emission tomography, Nodal basin, Metastases, Thin melanoma, Screening
Plan
Vol 221 - N° 4
P. 737-740 - avril 2021 Retour au numéro
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