FDG PET Imaging for Melanoma

PET/CT is approved by Medicare for use in staging, restaging and detecting recurrence in melanoma. Research suggests that PET/CT should not be considered as a replacement for sentinel node biopsy (1).

1. Acland e tal. Comparison of PET scanning and sentinel node biopsy in the detection of micrometastases of primary cutaneous malignant melanoma. J Clin Onc, Vol. 19, No. 10 2001: pp 2674-2678.

2004 Melanoma Statistics*

  • Estimated New Cases 55,100
  • Estimated New Deaths 7,910

*All cancer statistics obtained from the American Cancer Society’s Cancer Facts and Figures available at www.cancer.org.

Melanoma & FDG PET Imaging Statistics**

Table 1: Utility of PET Imaging in Staging Melanoma (N=1327)

  PET CT
Sensitivity 83% 88%
Specificity 91% 75%
PPV 70% N/A
NPV 85% N/A
Accuracy 91% 80%

For this patient population there was a 26% change in the way the physician managed the patient’s disease based on the results of the PET scan.

** Reprinted by permission of the Society of Nuclear Medicine from: Gambhir, Sanjiv S., Czernin, Johannes, Schwimmer, Judy, Silverman, Daniel H.S., Coleman, R. Edward, Phelps, Michael E. “A Tabulated Summary of the FDG PET Literature” J Nucl Med 2001 42: 1-93.

Case Study
Patient: 55yo male with a history of melanoma. Patient now presents with new axillary lymph node enlargement. PET/CT was ordered to characterize lesion and restage the patient.

Results: PET/CT revealed multiple areas of cancer that were not seen with CT-alone. The patient was upstaged to stage IV.