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

Eur J Surg Oncol. 2010 Feb;36(2):189-94. doi: 10.1016/j.ejso.2009.08.010. Epub 2009 Sep 22.


Background: Microscopically complete (R0) resection of metastases from uveal melanoma prolongs median overall survival compared to incomplete surgery. The aim of this study was to compare the sensitivity of dynamic-enhanced magnetic resonance imaging (MRI) with fluorodeoxyglucose-positron emission tomography (FDG-PET) in the preoperative diagnosis of liver metastases from uveal melanoma.

Patients and methods: Fifteen consecutive patients (mean age: 56 years) underwent FDG-PET and liver MRI. Extrahepatic metastatic disease was excluded by whole body computed tomography and bone scintigraphy. MRI and FDG-PET were performed with a mean of 19 days (range: 1-30) before surgery. Imaging findings were compared with surgical (including intraoperative ultrasonography) and histological findings on a lesion by lesion analysis.

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 5mm, 7 measured 5-10mm and 11 were larger than 10mm. 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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery
  • Magnetic Resonance Imaging*
  • Male
  • Melanoma / diagnosis*
  • Melanoma / secondary*
  • Melanoma / surgery
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Uveal Neoplasms / pathology*


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18