Diagnostic accuracy of contrast-enhanced FDG-PET/CT in primary staging of cutaneous malignant melanoma

Eur J Nucl Med Mol Imaging. 2009 Jun;36(6):910-8. doi: 10.1007/s00259-008-1049-x. Epub 2009 Jan 21.


Purpose: To evaluate the diagnostic accuracy of contrast-enhanced FDG-PET/CT (ce-PET/CT), PET-only, and CT-only in patients with newly diagnosed and resected cutaneous malignant melanoma.

Methods: A final group of 56 patients (mean age 62 years, range 23-86 years; 29 women, 27 men) were staged with ce-PET/CT after resection of the primary tumour. Histopathology as well as clinical follow-up (mean 780 days, range 102-1,390 days) served as the standards of reference. Differences between the staging modalities were tested for statistical significance with McNemar's test.

Results: All imaging procedures provided low sensitivities in the detection of lymph nodes (sensitivity N-stage: PET/CT and PET-only 38.5%; CT-only 23.1%) and distant metastases (sensitivity M-stage: PET/CT 41.7%, PET-only 33.3%, CT-only 25.0%) in initial staging after resection of the primary tumour. No statistically significant differences were detected between the imaging procedures (p > 0.05). PET/CT resulted in an alteration in further treatment in two patients compared to PET-only and in four patients compared to CT-only.

Conclusion: All imaging modalities had a low sensitivity on initial staging of patients with malignant melanoma. Thus, close patient follow-up must be considered mandatory.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Female
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma / diagnosis*
  • Melanoma / diagnostic imaging
  • Melanoma / pathology*
  • Middle Aged
  • Neoplasm Metastasis / diagnostic imaging
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Sensitivity and Specificity
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / pathology*
  • Time Factors
  • Tomography, X-Ray Computed


  • Contrast Media
  • Fluorodeoxyglucose F18