Eigtved A, Andersson A P, Dahlstrøm K, Rabøl A, Jensen M, Holm S, Sørensen S S, Drzewiecki K T, Højgaard L, Friberg L
Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen University Hospital, Denmark.
Eur J Nucl Med. 2000 Jan;27(1):70-5. doi: 10.1007/pl00006666.
Correct staging is crucial for the management and prognosis of patients with malignant melanoma. The aim of this prospective study was to compare staging by whole-body positron emission tomography using fluorine-18 fluorodeoxyglucose (18F-FDG) with staging by conventional methods. Thirty-eight patients with malignant melanoma of clinical stage II (local recurrence, in-transit and regional lymph node metastases) or III (metastases to other sites than in stage II) were included in the study. The results of the PET scans were compared with those obtained by clinical examination, computed tomography, ultrasound, radiography, and liver function tests and histology or clinical follow-up. With 18F-FDG PET we found for all foci a sensitivity of 97% and a specificity of 56%, compared with 62% and 22%, respectively, when using routine methods. For intra-abdominal foci, the sensitivity and specificity were 100% for both 18F-FDG PET and routine methods. Corresponding figures for pulmonary/intrathoracic foci were 100% and 33%, respectively. Of the patients included in this study, 34% would not have been staged correctly by conventional methods alone. We conclude from this study that 18F-FDG PET is a sensitive method superior to conventional methods for detecting widespread metastases from malignant melanoma. Mutilating surgery of no benefit can thereby be avoided. 18F-FDG PET is useful as a supplement to clinical examination in melanoma staging.
准确分期对于恶性黑色素瘤患者的治疗和预后至关重要。本前瞻性研究的目的是比较使用氟-18氟脱氧葡萄糖（18F-FDG）的全身正电子发射断层扫描分期与传统方法分期。38例临床分期为II期（局部复发、途中转移和区域淋巴结转移）或III期（转移至II期以外的其他部位）的恶性黑色素瘤患者纳入本研究。将PET扫描结果与通过临床检查、计算机断层扫描、超声、放射照相、肝功能检查以及组织学检查或临床随访获得的结果进行比较。使用18F-FDG PET时，我们发现所有病灶的敏感性为97%，特异性为56%，而使用常规方法时，敏感性和特异性分别为62%和22%。对于腹腔内病灶，18F-FDG PET和常规方法的敏感性和特异性均为100%。肺/胸腔内病灶的相应数字分别为100%和33%。本研究纳入的患者中，34%仅通过传统方法无法正确分期。我们从本研究得出结论，18F-FDG PET是一种敏感的方法，在检测恶性黑色素瘤广泛转移方面优于传统方法。由此可以避免无益的致残性手术。18F-FDG PET作为黑色素瘤分期临床检查的补充很有用。
