PET/CT in malignant melanoma: contrast-enhanced CT versus plain low-dose CT View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-05

AUTHORS

Thomas Pfluger, Henriette Ingrid Melzer, Vera Schneider, Christian La Fougere, Eva Coppenrath, Carola Berking, Peter Bartenstein, Mayo Weiss

ABSTRACT

PURPOSE: The aim of this study was to evaluate the diagnostic value of contrast-enhanced CT (CECT) versus non-enhanced low-dose CT (NECT) in the staging of advanced malignant melanoma with (18)F-fluordeoxyglucose (FDG) positron emission tomography (PET)/CT. METHODS: In total, 50 (18)F-FDG PET/CT examinations were performed in 50 patients with metastasized melanoma. For attenuation correction, whole-body NECT was performed followed by diagnostic CECT with contrast agent. For the whole-body PET, (18)F-FDG was applied. Criteria for evaluation were signs of vital tumour tissue (extent of lesions, contrast enhancement, maximum standardized uptake value >2.5). Findings suspicious for melanoma were considered lesions. NECT, CECT and (18)F-FDG PET were evaluated separately, followed by combined analysis of PET/NECT and PET/CECT. Findings were verified histologically and/or by follow-up (>6 months). RESULTS: Overall, 232 lesions were analysed, and 151 proved to be metastases. The sensitivity of NECT, CECT, PET, PET/NECT and PET/CECT was 62, 85, 90, 97 and 100%, and specificity was 52, 63, 88, 93 and 93%, respectively. Compared to CECT, NECT obtained additional false-negative results: lymph node (n = 19) and liver/spleen metastases (n = 9). Misinterpreted physiological structures mainly caused additional false-positive findings (n = 17). In combined analysis of PET/NECT, six false-positive [other tumours (n = 2), inflammatory lymph nodes (n = 2), inflammatory lung lesion (n = 1), blood vessel (n = 1)] and five false-negative findings [liver (n = 3), spleen (n = 1), lymph node metastases (n = 1)] remained. On PET/CECT, six false-positive [inflammatory lymph nodes (n = 3), other tumours (n = 2), inflammatory lung lesion (n = 1)] and no false-negative findings occurred. However, additional false findings on PET/NECT (6 of 232) did not change staging compared to PET/CECT. CONCLUSION: Our results indicate that it is justified to perform PET/NECT instead of PET/CECT for melanoma staging. More... »

PAGES

822-831

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00259-010-1702-z

DOI

http://dx.doi.org/10.1007/s00259-010-1702-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1035065355

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21210112


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