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Abstract |
The Value of FDG-PET Whole Body Imaging, Conventional Imaging, and Serum S-100 Determinations in Metastatic Malignant Melanoma |
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The clinical signifrcance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and S-100 determinations for metastatic lesions in patients with malignant melanoma was compared to a block of conventional imaging methods (CIM) including CT, X-ray, MRI, SPECT and sonography. Imaging was performed on 147 patients. Metastatic lesions were found in 57 patients, and 150 lesions were detected in lymph nodes, lung, liver, bone and brain. Comparing lesion by lesion, sensitivities of PET and CIM were 89% and76%, respectively. 65% of the 150 detectable lesions were found by both PET and CIM. The number of additionalty detected lesions was 24% by PET, and only 10% by CIM. PET and S-100 were compared in a subgroup of 75 patients with suspected metastatic disease. The sensitivities for PET and 5-100 were 100% and 76% at specificities of 97% and 98%. The positive predictive values were 96% for PET and 70% for S-100, and the negative predictive values were 100% for PET and 90% for S-100, respectively. The classification used for staging does not allow to differentiate melanoma patients according to the number of lymph nodes or to detect and localize lesions by in vitro S-100 determinations. This task is a matter of imaging methods, guided by PET whole body examination. However, elevated S-100 determinations could be an inexpensive method for follow up as an adjunct to PET. The combined use of these methods could be of more diagnostic signifïcance and seems to result in improved cost-effectiveness. |
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