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Oncology-Clinical Diagnosis: Solid TumorsMelanoma and Other Tumors |
1 Nuclear Medicine; 2 Department of Dermatology, TU Muenchen, Muenchen, Germany
578
Objectives: To assess the prognostic value of FDG PET/CT in patients with history of melanoma and to predict recurrent disease compared to the tumor markers S-100B / MIA.
Methods: 122 consecutive patients that underwent FDG PET/CT were retrospectively included in this study; 36 had elevated S-100B (>100pg/ml) and 24 elevated MIA (>10 pg/ml) levels. Histology, morphologic imaging and clinical follow up served as standard of reference.
Results: Out of 122 patients, FDG PET/CT was positive in 61 patients. In two cases PET/CT was false positive (neurinoma, chronic lymphatic leukemia) and in one case false negative (brain metastases). Overall sensitivities for S-100B, MIA and FDG PET/CT were 45% (27/60), 36% (21/59) and 98% (59/60); corresponding specificities were 85% (53/62), 95% (59/62) and 97% (60/62). ROC analyses revealed areas under the curve (AUCs) of 0.627 and 0.673 for S-100B and MIA. Patients with elevated S-100B and MIA values and PET/CT positive findings showed a significant poorer survival (log rank, p<0.001, p<0.001, p<0.001).
Conclusions: FDG PET/CT, MIA and S-100B show a high predictive value and provide important prognostic information in patients with history of malignant melanoma and suspected recurrence. FDG PET/CT has a higher sensitivity and specificity compared to S-100B and MIA. FDG PET/CT therefore accurately identifies patients with recurrence and excludes recurrent disease.
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