A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy

Steven E. Finkelstein, Jorge A. Carrasquillo, John M. Hoffman, Barbara Galen, Peter Choyke, Donald E. White, Steven A. Rosenberg, Richard M. Sherry

Research output: Contribution to journalArticle

Abstract

Background: Positron emission tomography with 2-deoxy-2-[ 18F]fluoro-d-glucose (FDG-PET) is available for evaluation of patients with melanoma. This study evaluates the potential of FDG-PET to improve on conventional imaging (CI) in patients with stage IV melanoma undergoing metastasectomy. Methods: This was a prospective study comparing radiological evaluation of patients who underwent metastasectomy for palliation or cure. Patients underwent preoperative evaluation by physical examination, CI by computed tomography and/or magnetic resonance imaging, and FDG-PET. Independent observers performed three separate analyses of CI alone, FDG-PET alone, or FDG-PET read with knowledge of CI (FDG-PET + CI). Abnormalities were reported as benign or malignant and assessed by pathologic analysis or by clinical outcome determined by disease progression detected on serial evaluations. Results: Ninety-four lesions were noted in 18 patients who underwent preoperative assessment, metastasectomy, and long-term follow up (median, 24 months). Lesion-by-lesion analysis for CI demonstrated a sensitivity of 76%, a specificity of 87%, a positive predictive value (PPV) of 86%, and a negative predictive value (NPV) of 76%. FDG-PET demonstrated a sensitivity of 79%, a specificity of 87%, a PPV of 86%, and an NPV of 80%. For FDG-PET + CI, the sensitivity was 88%, specificity was 91%, and PPV and NPV were 91% and 88%, respectively. Conclusions: Combined use of FDG-PET and CI may be an accurate strategy to identify sites of disease in patients with stage IV melanoma being considered for metastasectomy. Interpreted independently, FDG-PET and CI seemed to be equivalent modalities. FDG-PET + CI had both the highest sensitivity on lesion-by-lesion analysis and the best accuracy on patient-by-patient analysis. Published by Lippincott Williams & Wilkins

Original languageEnglish (US)
Pages (from-to)731-738
Number of pages8
JournalAnnals of Surgical Oncology
Volume11
Issue number8
DOIs
StatePublished - 2004
Externally publishedYes

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Metastasectomy
Positron-Emission Tomography
Melanoma
Physical Examination
Disease Progression
Tomography
Magnetic Resonance Imaging
Prospective Studies
Glucose

Keywords

  • Cancer
  • FDG-PET
  • Imaging
  • Melanoma
  • Metastasectomy
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy. / Finkelstein, Steven E.; Carrasquillo, Jorge A.; Hoffman, John M.; Galen, Barbara; Choyke, Peter; White, Donald E.; Rosenberg, Steven A.; Sherry, Richard M.

In: Annals of Surgical Oncology, Vol. 11, No. 8, 2004, p. 731-738.

Research output: Contribution to journalArticle

Finkelstein, Steven E. ; Carrasquillo, Jorge A. ; Hoffman, John M. ; Galen, Barbara ; Choyke, Peter ; White, Donald E. ; Rosenberg, Steven A. ; Sherry, Richard M. / A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy. In: Annals of Surgical Oncology. 2004 ; Vol. 11, No. 8. pp. 731-738.
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abstract = "Background: Positron emission tomography with 2-deoxy-2-[ 18F]fluoro-d-glucose (FDG-PET) is available for evaluation of patients with melanoma. This study evaluates the potential of FDG-PET to improve on conventional imaging (CI) in patients with stage IV melanoma undergoing metastasectomy. Methods: This was a prospective study comparing radiological evaluation of patients who underwent metastasectomy for palliation or cure. Patients underwent preoperative evaluation by physical examination, CI by computed tomography and/or magnetic resonance imaging, and FDG-PET. Independent observers performed three separate analyses of CI alone, FDG-PET alone, or FDG-PET read with knowledge of CI (FDG-PET + CI). Abnormalities were reported as benign or malignant and assessed by pathologic analysis or by clinical outcome determined by disease progression detected on serial evaluations. Results: Ninety-four lesions were noted in 18 patients who underwent preoperative assessment, metastasectomy, and long-term follow up (median, 24 months). Lesion-by-lesion analysis for CI demonstrated a sensitivity of 76{\%}, a specificity of 87{\%}, a positive predictive value (PPV) of 86{\%}, and a negative predictive value (NPV) of 76{\%}. FDG-PET demonstrated a sensitivity of 79{\%}, a specificity of 87{\%}, a PPV of 86{\%}, and an NPV of 80{\%}. For FDG-PET + CI, the sensitivity was 88{\%}, specificity was 91{\%}, and PPV and NPV were 91{\%} and 88{\%}, respectively. Conclusions: Combined use of FDG-PET and CI may be an accurate strategy to identify sites of disease in patients with stage IV melanoma being considered for metastasectomy. Interpreted independently, FDG-PET and CI seemed to be equivalent modalities. FDG-PET + CI had both the highest sensitivity on lesion-by-lesion analysis and the best accuracy on patient-by-patient analysis. Published by Lippincott Williams & Wilkins",
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T1 - A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy

AU - Finkelstein, Steven E.

AU - Carrasquillo, Jorge A.

AU - Hoffman, John M.

AU - Galen, Barbara

AU - Choyke, Peter

AU - White, Donald E.

AU - Rosenberg, Steven A.

AU - Sherry, Richard M.

PY - 2004

Y1 - 2004

N2 - Background: Positron emission tomography with 2-deoxy-2-[ 18F]fluoro-d-glucose (FDG-PET) is available for evaluation of patients with melanoma. This study evaluates the potential of FDG-PET to improve on conventional imaging (CI) in patients with stage IV melanoma undergoing metastasectomy. Methods: This was a prospective study comparing radiological evaluation of patients who underwent metastasectomy for palliation or cure. Patients underwent preoperative evaluation by physical examination, CI by computed tomography and/or magnetic resonance imaging, and FDG-PET. Independent observers performed three separate analyses of CI alone, FDG-PET alone, or FDG-PET read with knowledge of CI (FDG-PET + CI). Abnormalities were reported as benign or malignant and assessed by pathologic analysis or by clinical outcome determined by disease progression detected on serial evaluations. Results: Ninety-four lesions were noted in 18 patients who underwent preoperative assessment, metastasectomy, and long-term follow up (median, 24 months). Lesion-by-lesion analysis for CI demonstrated a sensitivity of 76%, a specificity of 87%, a positive predictive value (PPV) of 86%, and a negative predictive value (NPV) of 76%. FDG-PET demonstrated a sensitivity of 79%, a specificity of 87%, a PPV of 86%, and an NPV of 80%. For FDG-PET + CI, the sensitivity was 88%, specificity was 91%, and PPV and NPV were 91% and 88%, respectively. Conclusions: Combined use of FDG-PET and CI may be an accurate strategy to identify sites of disease in patients with stage IV melanoma being considered for metastasectomy. Interpreted independently, FDG-PET and CI seemed to be equivalent modalities. FDG-PET + CI had both the highest sensitivity on lesion-by-lesion analysis and the best accuracy on patient-by-patient analysis. Published by Lippincott Williams & Wilkins

AB - Background: Positron emission tomography with 2-deoxy-2-[ 18F]fluoro-d-glucose (FDG-PET) is available for evaluation of patients with melanoma. This study evaluates the potential of FDG-PET to improve on conventional imaging (CI) in patients with stage IV melanoma undergoing metastasectomy. Methods: This was a prospective study comparing radiological evaluation of patients who underwent metastasectomy for palliation or cure. Patients underwent preoperative evaluation by physical examination, CI by computed tomography and/or magnetic resonance imaging, and FDG-PET. Independent observers performed three separate analyses of CI alone, FDG-PET alone, or FDG-PET read with knowledge of CI (FDG-PET + CI). Abnormalities were reported as benign or malignant and assessed by pathologic analysis or by clinical outcome determined by disease progression detected on serial evaluations. Results: Ninety-four lesions were noted in 18 patients who underwent preoperative assessment, metastasectomy, and long-term follow up (median, 24 months). Lesion-by-lesion analysis for CI demonstrated a sensitivity of 76%, a specificity of 87%, a positive predictive value (PPV) of 86%, and a negative predictive value (NPV) of 76%. FDG-PET demonstrated a sensitivity of 79%, a specificity of 87%, a PPV of 86%, and an NPV of 80%. For FDG-PET + CI, the sensitivity was 88%, specificity was 91%, and PPV and NPV were 91% and 88%, respectively. Conclusions: Combined use of FDG-PET and CI may be an accurate strategy to identify sites of disease in patients with stage IV melanoma being considered for metastasectomy. Interpreted independently, FDG-PET and CI seemed to be equivalent modalities. FDG-PET + CI had both the highest sensitivity on lesion-by-lesion analysis and the best accuracy on patient-by-patient analysis. Published by Lippincott Williams & Wilkins

KW - Cancer

KW - FDG-PET

KW - Imaging

KW - Melanoma

KW - Metastasectomy

KW - Surgery

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