Detectability of liver metastases in malignant melanoma: prospective comparison of magnetic resonance imaging and positron emission tomography

Ghanem, Nadir; Altehoefer, Carsten; Högerle, S.; Nitzsche, Egbert U.; Lohrmann, Christian; Schäfer, Oliver; Kotter, Elmar; Langer, Mathias

doi:10.1016/j.ejrad.2004.07.005

Cited by 35 publications

(24 citation statements)

References 22 publications

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“…The sensitivity of FDG-PET detection of liver metastases of 45% is one of the lowest rates reported in the literature, but is nevertheless equivalent to that reported by Ghanem concerning liver metastases from cutaneous melanoma, with a sensitivity of FDG-PET of 47%. 10 In a recent review, Rappeport reported sensitivities of FDG-PET for the detection of liver metastases from colorectal cancers between 65 and 87%. 14 Three of these studies reported a particularly low detection rate for lesions smaller than 1 cm.…”

Section: Fdg-pet Versus Mri Imagingmentioning

confidence: 99%

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Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

Servois

Mariani

Malhaire

et al. 2010

European Journal of Surgical Oncology (EJSO)

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To cite this version:V. Servois, P. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Results: R0 resection was performed in 12 patients. A total of 28 lesions were resected with 27 histologically proven metastases. Nine lesions were smaller than 5 mm, 7 measured 5 -10 mm and 11 were larger than 10 mm. Sensitivity and positive predictive value were 67% and 95% for MRI compared to 41% and 100% for FDG-PET. The difference between the two modalities was statistically significant (p = 0.01; McNemar test). In remaining 3 patients, diffuse miliary disease (>10 capsular lesions) was discovered intraoperatively, and was suspected on preoperative MRI in 2 cases. Only one extrahepatic lesion identified by FDG-PET was falsely positive. Conclusions:In this preliminary study, MRI was superior to FDG-PET for staging of liver metastases from uveal melanoma. Although miliary disease was suggested by MRI in some cases, preoperative confirmation remains imperfect.

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Section: Fdg-pet Versus Mri Imagingmentioning

confidence: 99%

“…9,10 Few studies have evaluated FDG-PET in uveal melanoma. [11][12][13] This whole body imaging modality presents the theoretical advantage of evaluating liver involvement while also detecting any extrahepatic one.…”

mentioning

confidence: 99%

Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

Servois

Mariani

Malhaire

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…Melanin content was also evaluated in studies aimed at correlating T1-weighted MR imaging hyperintensity of melanoma lesions with pigmentation. In this context, pigmented lesions were observed in about 50% of patients (22,23). Most pigmented samples corresponded to positive 123 I-BZA2 scintigraphy results with a visually high ratio of background to tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Several preclinical studies, together with a phase II trial from our group, showed that 123 I-BZA2 might prove useful for melanoma staging (8)(9)(10)(11)23).…”

Section: Discussionmentioning

confidence: 99%

¹²³I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial

et al. 2013

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Our group has developed a new radiopharmaceutical, 123 I-N-(2-diethylaminoethyl)-2-iodobenzamide ( 123 I-BZA2), a benzamide derivative able to bind to melanin pigment in melanoma cells. In a prospective and multicentric phase III clinical study, the value of 18 F-FDG PET/CT and 123 I-BZA2 scintigraphy was compared for melanoma staging. Methods: Patients with a past history of cutaneous or ocular melanoma were included from 8 hospitals. 18 F-FDG imaging was performed according to a standard PET protocol. Whole-body, static planar, and SPECT/CT (if available) images were acquired 4 h after injection of a 2 MBq/kg dose of 123 I-BZA2. 18 F-FDG and 123 I-BZA2 sensitivity and specificity for the diagnosis of melanoma metastasis were calculated and compared on both a lesion basis and a patient basis. True-positive and true-negative lesion status was determined after 6 mo of clinical follow-up or according to lesion biopsies (if available). Melanin content in biopsies was evaluated with the standard Fontana-Masson silver method and was correlated with 123 I-BZA2 uptake. Based on statistical analysis, the number of inclusions was estimated at 186. Results: In all, 87 patients were enrolled from 2008 to 2010. Of these, 45 (52%) had metastases. A total of 338 imaging abnormalities were analyzed; 86 lesions were considered metastases, and 20 of 25 lesion biopsies found melanoma metastases. In a patient-based analysis, the sensitivity of 18 F-FDG for diagnosis of melanoma metastases was higher than that of 123 I-BZA2, at 87% and 39%, respectively (P , 0.05). For specificity, 18 F-FDG and 123 I-BZA2 were not statistically different, at 78% and 94%, respectively. In a lesion-based analysis, the sensitivity of 18 F-FDG was statistically higher than that of 123 I-BZA2 (80% vs. 23%, P , 0.05). The specificity of 18 F-FDG was lower than that of 123 I-BZA2 (54% vs. 86%, P , 0.05). According to biopsy analysis, only 9 of 20 metastatic lesions (45%) were pigmented with high melanin content. 123 I-BZA2 imaging was positive for 6 of 8 melanin-positive lesions, fairly positive for 3 of 10 melanin-negative lesions, and negative for 7 of 10 melaninnegative lesions. The sensitivity and specificity of 123 I-BZA2 for the diagnosis of melanin-positive lesions were 75% and 70%, respectively. Because of a low 123 I-BZA2 sensitivity, this clinical trial was prematurely closed after 87 patients had been included. Conclusion: This study confirms the value of 18 F-FDG PET/CT for melanoma staging and strengthens the high accuracy of 123 I-BZA2 for diagnosis of melanin-positive metastatic melanoma. Moreover, benzamide derivatives radiolabeled with therapeutic radionuclide may offer a new strategy for the treatment of metastatic melanoma patients harboring melanin-positive metastases. Mel anoma accounts for nearly 80% of all deaths related to cutaneous cancer (1). It is the second most common cancer among patients in their second decade (2). For localized lesions with a tumor thickness of less than 1.5 mm (stage I or II), melanoma can be cured by tota...

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“…The most common MRI finding associated with metastatic melanoma is a mass showing hypointense T1-weighted (T1W) signal intensity (SI) and hyperintense T2-weighted(T2W)SI,whicharenonspecificimagingcharacteristicsthatcanbeseenwithotherpathologicchanges [18]. AbdominalMRIhasbeenrecommendedinthestagingof melanoma patients, because MRI can detect more liver metastases compared with CT and US and differentiate benign frommetastaticlesions [19].MRIhasahighlesion/livercontrastratio.MetastasesofmelanomamaybevariableinT1W andT2WSIbutareusuallyhypointensetoisointenseonT1W imagesandisointensetoslightlyhyperintenseonT2Wimages relativetothesurroundingliverparenchyma,usuallywithan SIsimilartothatofthespleen [20].Müller-Horvatetal. [16] reported that MRI was superior to CT in the diagnosis of small hepatic metastases, and MRI was able to demonstrate more lesions than CT.…”

Section: Role Of Mri In the Diagnosis Of Melanomamentioning

confidence: 99%

Role of Imaging Methods in Metastatic Melanoma

Li¹,

Yang

2012

Onkologie

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Melanoma is a malignant neoplasm of the skin deriving from melanocytes. Accounting for less than 5% of all skin cancers, melanoma is associated with approximately 75% of skin cancer-related mortality. Early detection of melanoma with surgical resection remains one of the critical factors determining favorable clinical outcomes for melanoma. Up to now, many imaging methods, such as ultrasound, computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT, have been used in the diagnosis of melanoma and metastases. This article reviews the application of imaging methods in metastatic melanoma.

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Detectability of liver metastases in malignant melanoma: prospective comparison of magnetic resonance imaging and positron emission tomography

Cited by 35 publications

References 22 publications

Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

¹²³I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial

Role of Imaging Methods in Metastatic Melanoma

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Detectability of liver metastases in malignant melanoma: prospective comparison of magnetic resonance imaging and positron emission tomography

Cited by 35 publications

References 22 publications

Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

123I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial

Role of Imaging Methods in Metastatic Melanoma

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¹²³I-BZA2 as a Melanin-Targeted Radiotracer for the Identification of Melanoma Metastases: Results and Perspectives of a Multicenter Phase III Clinical Trial