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  • Title: Initial staging of malignant melanoma by positron emission tomography and sentinel node biopsy.
    Author: Libberecht K, Husada G, Peeters T, Michiels P, Gys T, Molderez C.
    Journal: Acta Chir Belg; 2005; 105(6):621-5. PubMed ID: 16438072.
    Abstract:
    UNLABELLED: By a retrospective study and literature review we aimed to evaluate the accuracy of Sentinel Node Biopsy (SNB) and F-18-fluorodeoxyglucose positron emission tomography (PET) for early detection of lymph node metastases. MATERIAL AND METHODS: Every patient presenting with a malignant melanoma without clinical lymph node involvement and a Breslow index over 1 mm or a recurrence was subjected to a preoperative PET scan and a sentinel node biopsy. Over a period of 10 months, 5 patients were included. They were submitted to conventional staging techniques, PET and SNB. RESULTS: In none of the patients the PET scan showed signs of lymph node involvement or distant metastases. However, two patients, both with a Breslow index of 1.4, had micrometastases in the sentinel node. CONCLUSION: Already in this small group of patients, PET scanning missed two metastases (40%). This is confirmed by several recent publications, stating that the resolution of positron emission tomography is about 5 mm and thus insufficient to detect micrometastases. Several larger series showed a sensitivity of PET to detect lymph node involvement of 15-50%. Therefore we conclude that PET is of limited use in these patients without palpable lymph nodes. Sentinel node biopsy however proves to be a useful tool and should be considered in the initial staging of malignant melanoma without palpable lymph node or distant metastases.
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