Impact of [18F]fluorodeoxyglucose positron emission tomography on surgical management of melanoma patients
Impact of [18F]fluorodeoxyglucose positron emission tomography on surgical management of melanoma patients
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DOI：
10.1002/bjs.5174
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发表时间：
2006-02-01
影响因子：
9.6
通讯作者：
Hoekstra, HJ
中科院分区：
文献类型：
--
作者：
Bastiaannet, E;Oyen, WJG;Hoekstra, HJ
背景：多项研究表明[F-18]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）对于检测黑色素瘤转移具有足够的敏感性和特异性，但很少有人探讨其对治疗的影响。这项回顾性研究的目的是评估 FDG-PET 对荷兰三所大学医疗中心黑色素瘤治疗的影响。方法：审查了 257 名患者的医疗记录。记录 FDG-PET 的适应症和结果。对除黑色素瘤之外的疑似（前期）恶性肿瘤的意外发现进行了评估。记录并分析 FDG-PET 前后的治疗计划，以评估疾病管理的变化。结果：大多数扫描 (71(.)2%) 需要进行分期，主要是为了检测 III 期疾病患者的远处转移。总体而言，56 名患者 (21(.)8%) 由于 PET 的结果而抢了风头。 44 名患者 (17(.)1%) 的治疗发生了改变，通常是从手术改为全身治疗（对于 III 期疾病的患者）。在 11 名患者 (4(.)3%) 中检测到意外肿瘤（主要是结直肠癌）。结论：FDG-PET 对于 III 期黑色素瘤患者最有价值，可用于检测远处转移并确定手术和/或全身治疗的候选者。不应忽视意外的 FDG-PET 结果，因为可以识别出恶性（前）、临床相关的肿瘤。
Background: Several studies have shown adequate sensitivity and specificity of [F-18]fluorodeoxyglucose positron emission tomography (FDG-PET) for the detection of metastases from melanoma, but few have addressed its impact on treatment. The aim of this retrospective study was to assess the impact of FDG-PET on treatment of melanoma in three Dutch university medical centres.Methods: The medical records of 257 patients were reviewed. The indications for FDG-PET and findings were recorded. Unexpected findings of suspected (pre)malignant tumours other than melanoma were assessed. Treatment plans before and after FDG-PET were recorded and analysed to evaluate changes in disease management.Results: Most scans (71(.)2 per cent) were requested for staging, mainly to detect distant metastases in patients with stage III disease. Overall, 56 patients (21(.)8 per cent) were upstaged as a result of PET. In 44 patients (17(.)1 percent) treatment was changed, usually from surgery to systemic treatment m patients with stage III disease. Unexpected tumours were detected (mainly colorectal) in 11 patients (4(.)3 per cent).Conclusion: FDG-PET is most valuable in patients with stage III melanoma for detection of distant metastases and identification of candidates for surgery and/or systemic treatment. Unexpected FDG-PET findings should not be disregarded, as (pre)malignant, clinically relevant, tumours may be identified.