Contribution of whole body F-18-FDG-PET and lymphoscintigraphy to the assessment of regional and distant metastases in cutaneous malignant melanoma -A pilot study

Aim: This pilot study describes use of whole body PET (WB PET) for staging of melonoma. WB PET in conjunction with lymphoscintigraphy (LS) for evaluat ing status of the sentinel lymph node (SLN) in primary melanoma was investi gated with comparison to histopathological results. WB PET was also used bo th for primary and metastatic melanoma for screening for distant metastases , restaging and follow-vp. Methods: Group 1: 17 patients with primary cutan eous melanoma underwent IS, WB PET and SLN dissection. WB PET findings were compared with biopsy results at the SLN site and were used for screening f or distant metastases. Group 11: 17 patients with a history of melanoma und erwent WB PET for follow-up and/or restaging. Results were confirmed or ref uted by other radiological modalities or by biopsy or clinical follow-up. R esults: Group I: out of 20 SLNs identified by LS in the 17 patients, 18 wer e negative on WB PET and 2 were positive. 19/20 WB PET findings were confir med either by histopathology or by clinical follow-up (20 mo). Accuracy was 94% for the assessment of the status of the SLN. Group II: WB PET findings altered staging and treatment in 12/17 patients and confirmed the validity of treatment in 3/17 patients. Overall, in 15/17 patients (88%), WB PET ha d on impact on treatment strategy Conclusion: Further studies ore required to demonstrate if WB PET con become a reliable non-invasive alternative to surgery in the characterization of the SLN. WB PET is important as a baseli ne in primary localized melonoma and decisively impacts patient management in metastatic melanoma.