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Danielsen M, Kjaer A, Wu M, et al. Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma. Am J Nucl Med Mol Imaging. 2016;6(5):277-285
Danielsen, M., Kjaer, A., Wu, M., Martineau, L., Nosrati, M., Leong, S. P., Sagebiel, R. W., Miller, J. R., & Kashani-Sabet, M. (2016). Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma. American journal of nuclear medicine and molecular imaging, 6(5), 277-285.
Danielsen, Maria, et al. "Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma." American journal of nuclear medicine and molecular imaging vol. 6,5 (2016): 277-285.
Danielsen M, Kjaer A, Wu M, Martineau L, Nosrati M, Leong SP, Sagebiel RW, Miller JR, Kashani-Sabet M. Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma. Am J Nucl Med Mol Imaging. 2016 Sep 22;6(5):277-285. eCollection 2016. PMID: 27766186; PMCID: PMC5069280.
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Am J Nucl Med Mol Imaging. 2016 Sep 22;6(5):277-285. eCollection 2016.

Prediction of positron emission tomography/computed tomography (PET/CT) positivity in patients with high-risk primary melanoma.

American journal of nuclear medicine and molecular imaging

Maria Danielsen, Andreas Kjaer, Max Wu, Lea Martineau, Mehdi Nosrati, Stanley Pl Leong, Richard W Sagebiel, James R Miller, Mohammed Kashani-Sabet

Affiliations

  1. Center for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteSan Francisco, California 95107, USA; University of CopenhagenCopenhagen, Denmark.
  2. Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen Copenhagen, Denmark.
  3. Department of Nuclear Medicine and Radiology, California Pacific Medical Center San Francisco, California 95107, USA.
  4. Center for Melanoma Research and Treatment, California Pacific Medical Center Research Institute San Francisco, California 95107, USA.

PMID: 27766186 PMCID: PMC5069280

Abstract

Positron emission tomography/computed tomography (PET/CT) is an important tool to identify occult melanoma metastasis. To date, it is controversial which patients with primary cutaneous melanoma should have staging PET/CT. In this retrospective analysis of more than 800 consecutive patients with cutaneous melanoma, we sought to identify factors predictive of PET/CT positivity in the setting of newly-diagnosed high-risk primary melanoma to determine those patients most appropriate to undergo a PET/CT scan as part of their diagnostic work up. 167 patients with newly-diagnosed high-risk primary cutaneous melanoma underwent a PET/CT scan performed as part of their initial staging. Clinical and histologic factors were evaluated as possible predictors of melanoma metastasis identified on PET/CT scanning using both univariate and multivariate logistic regression. In all, 32 patients (19.2%) had a positive PET/CT finding of metastatic melanoma. In more than half of these patients (56.3%), PET/CT scanning identified disease that was not detectable on clinical examination. Mitotic rate, tumor thickness, lymphadenopathy, and bleeding were significantly predictive of PET/CT positivity. A combinatorial index constructed from these factors revealed a significant association between number of high-risk factors observed and prevalence of PET/CT positivity, which increased from 5.8% (with the presence of 0-2 factors) to 100.0%, when all four factors were present. These results indicate that combining clinical and histologic prognostic factors enables the identification of patients with a higher likelihood of a positive PET/CT scan.

Keywords: FDG; Melanoma; PET; PET/CT; molecular imaging; nuclear medicine; skin cancer; staging

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