1. Whole Body 18F-FDG PET/CT Imaging Staging of Malignant Melanoma:
Experience With 25 Consecutive Patients
DR SIKANDAR SHAIKH
YASHODA HOSPITALS
HYDERABAD

2. PURPOSE: To assess the diagnostic performance of
Positron emission tomography/Computed tomography (PET/CT) using 18F-fluorodeoxyglucose (FDG) for
N- and M-staging of cutaneous melanoma.

3. PATIENTS AND METHODS:
This is a retrospective study of 25 consecutive patients
(10women, 15 men; age 58 ± 16 years)
who underwent FDG-PET/CT for staging of cutaneous melanoma
at different time points in the course of disease.
Whole-body FDG-PET/CT was performed 90 ± 20minutes
post injection of milliquirie of FDG.
Diagnostic accuracy for was determined for CT alone, PET alone, and PET/CT.

4. RESULTS:
PET/CT detected significantly more visceral and non visceral metastases
than PET alone and CT alone
(98.7%, 88.8%, and 69.7%, respectively).
PET/CT imaging thus provided significantly more
accurate interpretations regarding overall staging than
PET alone and CT alone.

5. Overall staging was correctly determined
PET/CT in 23 of 25 patients (97.2%; 95% CI, 95.2% to 99.4%)
PET 22 patients (92.8%; 95% CI, 89.6% to 96.0%),
CT 19 patients (78.8%; 95% CI, 73.7% to 83.9%) .
All differences were significant.
Accuracy of PET/CT was significantly higher than that of PET
and CT for M-staging (0.98 v 0.93 and 0.84)
Significantly higher than that of CT for N-Staging (0.98 v 0.86).
Change of treatment according to PET/CT findings occurred in
12 patients (48.4%).

6. Melanoma with multiple cutaneous nodules
56 years male with multiple nodules
Since last 6 months
Itching with pain
Non responding to medical theraphy
Biopsy showed malignant melanoma

7. Bone metastases Known case of melanoma foot Post chemotherapy
Complaints with upper backache

8. Malignant melanoma 61 years male Gradually progressive scalp swelling
On and off pain
Non responding to routine treatment
Biopsy revealed melanoma

9. Melanoma of tibia 53 years male Intermittent pain around knee
Radiograph showed patchy sclerosis of tibia
Bone scan hot spot
Biopsy revealed melanoma

10. Melanoma with extensive metastases
49 years
Melanoma right foot
Post radiotherapy
Extensive metastases

11. Melanoma right foot 57 years female History of pain in heel
No response to analgesics
Diagnosed as fscitis clinically
Biopsy showed melnoma

12. Melanoma left leg and foot staging

13. Right axillary melanoma
62 years with small axillary nodule
Non responding to treatment
Biopsy -melanoma

14. CONCLUSION: The diagnostic performance of FDG-PET/CT
for staging of melanoma patients suggests its wide use for
staging, especially for distant metastases.

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