Damian D L, Fulham M J, Thompson E, Thompson J F
Sydney Melanoma Unit, Royal Prince Alfred Hospital, Camperdown NSW, Australia.
Melanoma Res. 1996 Aug;6(4):325-9. doi: 10.1097/00008390-199608000-00008.
Initial reports suggest that positron emission tomography with [18F]fluorodeoxyglucose (FDG-PET) may offer greater diagnostic accuracy and versatility than conventional radiology in staging patients with metastatic melanoma. We reviewed the first 100 melanoma patients to have PET imaging at our institution. PET findings were correlated with all other available results, including plain X-ray, computed tomography (CT), magnetic resonance (MR) imaging, bone scintigraphy, clinical findings and histopathology. A total of 415 metastatic lesions were evaluated, 388 (93%) of which were detected by PET. In 20 patients, PET detected 24 metastases up to 6 months earlier than conventional imaging or physical examination. Selection of surgical or medical management was specifically influenced by PET findings in 22 patients, and PET was used to clarify another 12 cases where CT was inconclusive. In nine patients undergoing chemotherapy, PET was used to assess response to treatment. We conclude that FDG-PET can accurately detect metastatic melanoma with a single non-invasive scan, and can demonstrate some metastases months before conventional imaging techniques. PET can improve the selection of patients for surgery, has potential for monitoring response to treatment and may prove a cost-effective means of staging melanoma patients.
初步报告表明，与传统放射学相比，采用[18F]氟脱氧葡萄糖的正电子发射断层扫描（FDG-PET）在转移性黑色素瘤患者分期方面可能具有更高的诊断准确性和多功能性。我们回顾了在我们机构接受PET成像的首批100例黑色素瘤患者。PET检查结果与所有其他可用结果相关，包括普通X线、计算机断层扫描（CT）、磁共振（MR）成像、骨闪烁显像、临床检查结果和组织病理学。总共评估了415个转移病灶，其中388个（93%）由PET检测到。在20例患者中，PET比传统成像或体格检查提前6个月检测到24处转移。PET检查结果对22例患者的手术或药物治疗选择产生了特殊影响，PET还用于明确另外12例CT检查结果不明确的病例。在9例接受化疗的患者中，PET用于评估治疗反应。我们得出结论，FDG-PET能够通过单次非侵入性扫描准确检测转移性黑色素瘤，并且能够在传统成像技术前数月发现一些转移灶。PET可以改善手术患者的选择，具有监测治疗反应的潜力，可能证明是一种对黑色素瘤患者进行分期的经济有效的方法。
