Evaluation of ¹⁸F-FDG PET/CT Parameters for Detection of Lymph Node Metastasis in Cutaneous Melanoma
10.1007/s13139-017-0495-4
- Author:
Jongtae CHA
1
;
Soyoung KIM
;
Jiyoung WANG
;
Mijin YUN
;
Arthur CHO
Author Information
1. Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-Ku, Seoul 120-752, South Korea. artycho@yuhs.ac
- Publication Type:Original Article
- Keywords:
Cutaneous melanoma;
FDG PET/CT;
Lymph nodemetastasis;
Sensitivity
- MeSH:
Electrons;
Follow-Up Studies;
Glycolysis;
Humans;
Lymph Nodes;
Melanoma;
Neoplasm Metastasis;
Positron-Emission Tomography and Computed Tomography;
Recurrence;
ROC Curve;
Sensitivity and Specificity
- From:Korean Journal of Nuclear Medicine
2018;52(1):39-45
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to investigate the value of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in the detection of regional lymph node (LN) metastasis in patients with cutaneous melanoma.METHODS: We evaluated patients with cutaneous melanoma who underwent FDG PET/CT for initial staging or recurrence evaluation. A total of 103 patients were enrolled, and 165 LNs were evaluated. LNs that were confirmed pathologically or by follow-up imaging were included in this study. PET parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis and tumour-to-liver ratio, were used to determine the presence of metastases, and the results were compared with CT-determined LN metastasis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values of the FDG PET parameters.RESULTS: A total of 93 LNs were malignant, and 84 LNs were smaller than 10 mm. In all 165 LNs, an SUVmax of >2.51 showed a sensitivity of 73.1%, a specificity of 88.9%, and an accuracy of 80.0% in detecting metastatic LNs. CT showed a higher specificity (87.3%) and lower accuracy (65.5%). For non-enlarged regional LNs ( < 10 mm), an SUVmax cut-off value of 1.4 showed the highest negative predictive value (81.3%). For enlarged LNs (≥10 mm), an SUVmax cut-off value of 2.4 showed the highest sensitivity (90.7%) and accuracy (88.9%) in detecting metastatic LNs.CONCLUSIONS: In patients with cutaneous melanoma, an SUVmax of >2.4 showed a high sensitivity (91%) and accuracy (89%) in detecting metastasis in LNs ≥1 cm, and LNs < 1 cm with an SUVmax < 1.4 were likely to be benign.
