Role of PET scan in the management of melanoma

1542 Objectives: Prognosis and treatment strategies in patients with malignant melanoma are determined by the stage of the disease. Patients with a small number of metastases limited may benefit from surgery; therefore, accurate staging is of great importance for disease management. In the following, we will explore the PET-CT role in staging malignant melanoma. Methods: We studied 82 patients in follow-up after surgery, having AJCC stage III melanoma and contrast-enhanced computed tomography (CT) total body negative. In all patients a whole body (legs included) PET/CT scan was performed after an intravenous injection of 444-518 MBq of 18F-FDG in normoglucemia conditions. Images were evaluated by 2 nuclear physicians. Results: Of the 82 PET/CT scans 28 showed 64 sites of active disease: 31 limph nodes (12 axillary, 2 parasternal, 3 supraclavicular, 8 external iliac, 4 bronchopulmonary, 2 paratracheal), 2 suprarenal gland, 2 bone, 23 subcutaneous and 6 skin. All PET/CT findings were confirmed by histology or clinical evolution; PET/CT caused changes of treatments. Conclusions: In our study PET/CT is superior to CT scan in detecting lymph nodes, skin and subcutaneous metastases. As everybody knows: the early detection of resectable melanoma metastases with early treatment decreases the risk of recurrence and increases survival.