Capsule endoscopy versus positron emission tomography for detection of small-bowel metastatic melanoma: a pilot study - 11/08/11
Reprint requests: Associate Professor Warwick S. Selby, MBBS, MD, FRACP, Suite 311, Royal Prince Alfred Hospital Medical Centre, 100 Carillon Avenue, Newtown, New South Wales, Australia 2042Résumé |
Background |
Melanoma is the most common tumor to metastasize to the GI tract, where it mainly involves the small bowel.
Objective |
To compare capsule endoscopy (CE) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT scanning, the current standard and most sensitive investigation modality, in detecting small-bowel metastases in patients with metastatic melanoma.
Design |
A prospective study of patients with metastatic melanoma who were undergoing FDG PET-CT scanning. CE was performed and the results read by two independent observers without knowledge of the other investigation results.
Setting |
Tertiary care centers.
Patients |
This study involved 21 patients with a median age of 52 years (range 22-88 years).
Intervention |
CE.
Main Outcome Measurements |
Detection of small-bowel melanoma.
Results |
FDG PET-CT scanning showed increased abdominal uptake in 12 patients, but only 5 of these patients were found to have small-bowel melanoma on CE. Importantly, in 1 patient with a bleeding small-bowel tumor on CE, the FDG PET-CT scan result was negative. One patient with positive FDG PET-CT scan results and negative CE results subsequently developed symptomatic small-bowel melanoma 10 months after CE.
Limitations |
Small-bowel melanoma could not be excluded entirely in 7 patients with positive FDG PET-CT scan results and negative CE results, and follow-up is ongoing. The number of patients in this study was small.
Conclusion |
CE was better than FDG PET-CT scanning in localizing small-bowel melanoma. This study suggests that CE is an ideal complementary investigation modality for patients with known metastatic melanoma undergoing preoperative work-ups and in those with unexplained anemia or GI symptoms.
Le texte complet de cet article est disponible en PDF.Abbreviations : CE, FDG, PET
Plan
| DISCLOSURE: Given Imaging provided the capsules for this study. W. Selby is a paid speaker and workshop participant for Given Imaging. No other financial relationships relevant to this publication were disclosed. |
Vol 73 - N° 4
P. 750-756 - avril 2011 Retour au numéro
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