TABLE 3.
Effect of PET on Change of Management Choices for Patients With Melanoma Reported in the Literature Since 2000
| Study | Year | Type of study |
No. of PET Scans/No. of Patients |
AJCC Clinical Stage |
Type of FDG-Labeled Imaging |
Overall Change in Management Based on PET/CT(%) |
Change in Surgical Management |
False- Positive Rate (%) |
Method of False-Positive Rate Calculation |
|---|---|---|---|---|---|---|---|---|---|
| Tyleret al.[4] | 2000 | Prospective | 106/95 | IIIC | PET | 15 | Not specifically reported | 56.5 | 39/69 lesions |
| Mijnhout et al.[9]a | 2002 | Prospective | 68/68 | 1–IV | PET | 40 | In 10% of cases, surgery was canceleda | 3 | 2/68 patients |
| Gulec et al.[10] | 2003 | Prospective | 49/49 | II–IV | PET | 49 | In 36% of cases, surgical plan was changed; in 24%, surgery was canceled; in 12%, additional surgery was performed | 8 | 4/49 patients |
| Harris et al. [12] | 2005 | Retrospective | 126/92 | I–IV | PET | 32 | In 15% of cases, surgery was canceled | 1.6 | 2/126 PET scans |
| Brady et al.[11] | 2006 | Prospective | 103/103 | IIC–IV | PET | 33 | In 19% of cases, surgery was canceled (only 5% based on PET alone) | 8 | 5/59 patients |
| Reinhardt et al.[13] | 2006 | Retrospective | 250/64 | I–IV | PET/CT | 48.4b | In 40% of cases, intermo-dality change; in 8.4%, intramodality change | 0.4 | 1/250 patients |
| Pfannenberg et al.[15] | 2007 | Prospective | 64/64 | III–IV | PET/CT | 57.6b | In 19% of cases, surgery was canceled; in 15% of cases, surgical field was amended | 9.4 | 28/297 lesions |
Note—AJCC = American Joint Committee on Cancer.
a
Imaging workup before PET did not include CT of the chest, abdomen, and pelvis but was variable, ranging from chest x-ray only to CT of two of three body parts.
b
No baseline conventional imaging was performed before PET/CT. Patients were evaluated only by physical examination and sentinel lymph node biopsy.