ABSTRACT
AIM: To assess the diagnostic and prognostic value of FDG-PET/CT in the follow-up of malignant melanoma in comparison to the serum protein S100B. PATIENTS AND METHODS: A total of ninety patients with either low-risk or high-risk malignant melanoma, respectively, were included in this study. The follow-up of the patients was pursuant with the guidelines of the German Dermatological Association. The diagnostic accuracy and diagnostic power were determined for PET/CT and for the serum protein S100B. RESULTS: In 28 of the 90 patients PET/CT was positive in the follow up, 47 patients had an elevated Serum S100B level. Sensitivity, specificity, PPV and NPV of PET/CT for the total groups of patients were 87%, 93%, 87% and 93%. The corresponding values for the serum protein S100B were 65%, 52%, 43% and 74%, respectively. PET/CT positive patients showed a significantly (p < 0.001) higher risk of melanoma associated death compared to patients with PET/CT negative findings. No statistical significance could be found in the 5 year survival rate between the S100B positive and S100B negative patients. CONCLUSION: PET/CT is suitable to confirm or exclude recurrences and can be used to assess the prognosis in melanoma patients. The diagnostic accuracy and the prognostic power is much higher compared to the serum protein S100B.
Subject(s)
Melanoma/diagnostic imaging , Melanoma/mortality , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/mortality , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/mortality , Survivors/statistics & numerical data , Biomarkers, Tumor/blood , Female , Fluorodeoxyglucose F18 , Germany/epidemiology , Humans , Male , Melanoma/blood , Middle Aged , Multimodal Imaging/statistics & numerical data , Neoplasm Recurrence, Local/blood , Positron-Emission Tomography , Prevalence , Prognosis , Radiopharmaceuticals , Reproducibility of Results , Risk Factors , S100 Calcium Binding Protein beta Subunit/blood , Sensitivity and Specificity , Survival Analysis , Tomography, X-Ray Computed/statistics & numerical dataSubject(s)
Fluorodeoxyglucose F18 , Histiocytoma, Benign Fibrous/diagnostic imaging , Positron-Emission Tomography/statistics & numerical data , Splenic Diseases/diagnostic imaging , Adult , False Positive Reactions , Female , Histiocytoma, Benign Fibrous/surgery , Humans , Lymphoma/diagnostic imaging , Splenectomy , Splenic Diseases/surgery , Tomography, X-Ray ComputedABSTRACT
PET imaging with the glucose analog fluorodeoxyglucose (FDG-PET) has been evaluated in several studies to monitor tumor response in patients undergoing chemo- and radiotherapy. The clinical value of FDG-PET for differentiation of residual tumor and therapy induced fibrosis has been documented for esophageal cancer. Furthermore, there are now several reports suggesting that quantitative assessment of therapy induced changes in tumor FDG-uptake may allow prediction of tumor response and patient outcome very early in the course of therapy. This suggests that FDG-PET may be used to identify non-responders early during neoadjuvant chemoradiotherapy allowing for early modifications of the treatment protocol.
Subject(s)
Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/therapy , Fluorodeoxyglucose F18 , Outcome Assessment, Health Care/methods , Positron-Emission Tomography/methods , Humans , Prognosis , Radiopharmaceuticals , Treatment OutcomeABSTRACT
Retention of surgical sponges is rare. They cause either an aseptic reaction without significant symptoms or an exudative reaction which results in early but non-specific symptoms. Even if there are no studies which compare the diagnostic accuracy of the different imaging modalities, CT seems to be the most promising tool to diagnose foreign bodies. However, apart from radio-paque markers there are no specific signs for the existence of surgical sponges in CT. Therefore, an experienced radiologist is needed to differentiate foreign bodies from morphologically quite similar differential diagnoses such as abscess and haematoma.