COMPUTED-TOMOGRAPHY FOR THE DETECTION OF NECK NODE METASTASES IN MELANOMA PATIENTS

Aims. To assess the value of CT scanning for detection of lymph node m etastases in the neck. Methods. The appearance and site of the metasta ses was studied, as well as the sensitivity and specificity of CT. Res ults. Nodal metastases did not always show a high contrast uptake and nodal density therefore cannot be used as a criterion for metastasis. Irregular contrast enhancement was seen in seven of the 21 tumour-posi tive necks. Frequently, metastases in the parotids, superficial nodes in the neck and in the posterior triangle were seen. The sensitivity a nd specificity of palpation and CT scanning were 87 and 100%, respecti vely. Conclusions. However, because small, clinically occult, melanoma metastases were frequently overlooked on CT, the role of this imaging modality in assessing occult metastases remains limited. Based on rec ent data from literature it is reasonable to speculate that ultrasound guided fine needle aspiration cytology (FNAC) will prove to be more e ffective than a non-invasive staging procedure of the neck in melanoma patients.