Nicol I, Chuto G, Gaudy-Marqueste C, Brenot-Rossi I, Grob J-J, Richard M-A
Service de dermatologie, hôpital Sainte-Marguerite, Marseille, France.
Bull Cancer. 2008 Nov;95(11):1089-101. doi: 10.1684/bdc.2008.0745.
The indications of FDG PET-CT are well established for some neoplasms, such as lung cancer and lymphoma. The role of FDG PET-CT for the management of cutaneous melanoma is less clear.
We successively describe the substances and machines used with PET-CT, and review the French recommendations and the latest scientific articles to determine which patients could benefit from this examination.
PET-CT is not indicated for the diagnosis of the malignancy of a suspicious cutaneous lesion, or for initial regional node staging. PET-CT is not indicated for the initial staging of melanoma without node involvement. PET-CT could be proposed for the staging of thick melanoma with macroscopic involvement of the sentinel node. PET-CT is useful for distant staging. The sole curative treatment of melanoma being surgery, the most useful indications of PET-CT are preoperative staging of one (or more) nodal or distant metastases, whether histologically confirmed or not. Preoperative PET-CT can spare a patient with unknown metastases a useless surgery. PET-CT is not indicated for the staging of a patient with known inoperable metastatic disease. PET-CT is not indicated for assessing response to chemotherapy, except in clinical trials.
FDG PET-CT在某些肿瘤（如肺癌和淋巴瘤）中的应用指征已得到充分确立。FDG PET-CT在皮肤黑色素瘤管理中的作用尚不清楚。
我们依次描述了PET-CT使用的物质和机器，并回顾了法国的相关建议和最新的科学文章，以确定哪些患者能从这项检查中获益。
PET-CT不适用于诊断可疑皮肤病变的恶性肿瘤，也不适用于初始区域淋巴结分期。PET-CT不适用于无淋巴结受累的黑色素瘤的初始分期。PET-CT可用于有前哨淋巴结宏观受累的厚黑色素瘤的分期。PET-CT对远处分期有用。黑色素瘤的唯一根治性治疗是手术，PET-CT最有用的指征是术前对一个（或多个）淋巴结或远处转移灶进行分期，无论是否经组织学证实。术前PET-CT可以使有未知转移灶的患者避免不必要的手术。PET-CT不适用于已知有不可切除转移性疾病患者的分期。PET-CT不适用于评估化疗反应，临床试验除外。
