Burns Deanna, George Jessica, Aucoin Danielle, Bower Jonathan, Burrell Steven, Gilbert Robert, Bower Nichole
School of Health Sciences Dalhousie University, Halifax, Nova Scotia, Canada.
Nuclear Medicine, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.
J Med Imaging Radiat Sci. 2019 Sep;50(3):460-469.e1. doi: 10.1016/j.jmir.2019.05.001. Epub 2019 Jun 14.
Cutaneous malignant melanoma (CM) is the leading cause of skin cancer-related mortality and accounts for approximately 1,250 deaths in Canada each year. It is also one of few cancers continuing to display rates of increasing incidence throughout the world. The past decade has brought significant growth in our understanding of the pathogenesis and clinical management of CM. This evidence-based review synthesizes that knowledge, beginning with a review of the epidemiology and etiology of the disease followed by a broad review of the roles of diagnostic imaging in its management. Special attention is given to the role of F-fluorodeoxyglucose (F-FDG) positron emission tomography-computed tomography (PET/CT) in supporting assessment at primary presentation of disease, follow-up to surgical and nonsurgical treatment, and for the surveillance of high-risk asymptomatic patients. After a brief review of current treatment options, this article concludes with a demonstration of how and when uncertainty exists at the point of care systematic review processes may be used to resolve clinical questions. Learning Objectives: By the end of this Continuing Medical Education article, participants will be able to 1. Describe the epidemiology and etiology of cutaneous melanoma, 2. Describe broadly the role of diagnostic imaging in the clinical management of cutaneous melanoma, 3. Describe the specific roles and limitations of F-FDG PET/CT in the clinical management of cutaneous melanoma, 4. Describe broadly the best practice in the treatment of cutaneous melanoma, 5. Define the value of systematic review for synthesizing knowledge pertaining to a specific clinical question, and 6. Discuss the utility of F FDG PET/CT in the management of early-stage (AJCC 0-IIc) cutaneous melanoma. This is a CME article and provides the equivalent of 2 hours of continuing education that may be applied to your professional development credit system. A 12-question multiple choice quiz follows this reading. Please note that no formalized credit (Category A) is available from CAMRT.
皮肤恶性黑色素瘤（CM）是皮肤癌相关死亡的主要原因，在加拿大每年约有1250人死于该病。它也是全球少数发病率持续上升的癌症之一。在过去十年中，我们对CM发病机制和临床管理的认识有了显著增长。本循证综述综合了这些知识，首先回顾了该疾病的流行病学和病因，随后广泛回顾了诊断成像在其管理中的作用。特别关注氟脱氧葡萄糖（F-FDG）正电子发射断层扫描-计算机断层扫描（PET/CT）在支持疾病初诊评估、手术和非手术治疗随访以及高危无症状患者监测方面的作用。在简要回顾当前治疗选择后，本文最后展示了在医疗点存在不确定性时如何以及何时可以使用系统综述流程来解决临床问题。学习目标：在这篇继续医学教育文章结束时，参与者将能够1. 描述皮肤黑色素瘤的流行病学和病因，2. 大致描述诊断成像在皮肤黑色素瘤临床管理中的作用，3. 描述F-FDG PET/CT在皮肤黑色素瘤临床管理中的具体作用和局限性，4. 大致描述皮肤黑色素瘤治疗的最佳实践，5. 定义系统综述在综合特定临床问题相关知识方面的价值，6. 讨论F-FDG PET/CT在早期（美国癌症联合委员会0-IIc期）皮肤黑色素瘤管理中的效用。这是一篇继续医学教育文章，提供相当于2小时的继续教育，可应用于您的专业发展学分系统。阅读本文后有一个12道题的多项选择题测验。请注意，加拿大医学放射技术协会不提供正式学分（A类）。
