Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0278883 (metastatic melanoma)
 6,224 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Initial reports suggest that positron emission tomography with [18F]fluorodeoxyglucose (FDG-PET) may offer greater diagnostic accuracy and versatility than conventional radiology in staging patients with metastatic melanoma. We reviewed the first 100 melanoma patients to have PET imaging at our institution. PET findings were correlated with all other available results, including plain X-ray, computed tomography (CT), magnetic resonance (MR) imaging, bone scintigraphy, clinical findings and histopathology. A total of 415 metastatic lesions were evaluated, 388 (93%) of which were detected by PET. In 20 patients, PET detected 24 metastases up to 6 months earlier than conventional imaging or physical examination. Selection of surgical or medical management was specifically influenced by PET findings in 22 patients, and PET was used to clarify another 12 cases where CT was inconclusive. In nine patients undergoing chemotherapy, PET was used to assess response to treatment. We conclude that FDG-PET can accurately detect metastatic melanoma with a single non-invasive scan, and can demonstrate some metastases months before conventional imaging techniques. PET can improve the selection of patients for surgery, has potential for monitoring response to treatment and may prove a cost-effective means of staging melanoma patients.
 ...
PMID:Positron emission tomography in the detection and management of metastatic melanoma. 887 53

Recently the potential of whole-body positron emission tomography scanning using 18F-fluorodeoxyglucose (FDG PET) has led to renewed interest in the use of functional imaging for the detection of occult metastatic melanoma. This study compared dedicated FDG PET with high-dose gallium-67 imaging incorporating whole-body scanning and comprehensive single-photon emission tomography (SPET) in 122 cases (121 patients) in which the two scans were performed <6 weeks apart. All patients were at high clinical risk of occult metastatic disease and 49 (40%) had abnormality suggestive of metastatic disease by at least one functional imaging technique. Discrepant scan findings were followed up to determine which technique more accurately reflected disease status. There were 23/122 (19%; 95% CI: 12%-26%) cases with discordant scan results in respect of either the presence of melanoma (11 cases) or the extent of disease (12 cases). PET correctly identified more disease than 67Ga SPET in 14 cases (including three incidental primary tumours) and was true negative in three further patients with abnormal 67Ga SPET. There were six patients with true positive 67Ga SPET in whom FDG PET was false negative (one small cutaneous deposit, one residual axillary node rated equivocal on FDG PET due to postoperative changes, one adrenal metastasis inseparable from renal activity on FDG PET and three cases in which sites missed on FDG PET were seen on 67Ga SPET. Thus, FDG PET provided incremental diagnostic information compared with 67Ga SPET in 17/23 patients, while 67Ga SPET provided incremental information compared with PET in 6/23 cases ( P=0.035). Based on Australian Medicare reimbursement levels, the net cost per patient with clinical management benefit of replacing 67Ga SPET with FDG PET was estimated to be less than EUR 1,750. These results suggest that FDG PET provides incremental and clinically important information in around 10% of patients at a low incremental cost which, combined with greater patient convenience and lower radiation dosimetry, make FDG PET the functional imaging technique of choice for evaluation of suspected metastatic melanoma.
 ...
PMID:Evaluation of high-risk melanoma: comparison of [18F]FDG PET and high-dose 67Ga SPET. 1191 89

A woman was referred for fluorodeoxyglucose positron emission tomography for the staging of a malignant melanoma. Although no signs of metastatic melanoma were evident on the whole-body scan, focally increased uptake within the femoral metaphysis was noted. Radiographic and magnetic resonance examinations revealed an enchondroma as the cause of the increased uptake. Histopathologic verification was obtained. The final diagnosis was actively proliferating enchondroma. A grade I chondrosarcoma could be ruled out. Enchondromas may be responsible for focally increased FDG uptake in bone lesions and must be considered when positron emission tomographic scans obtained with FDG are evaluated in cancer staging.
 ...
PMID:Enchondroma: a benign osseous lesion with high F-18 FDG uptake. 1235 8

Early detection of melanoma is essential, since a patient's prognosis with metastatic melanoma is poor. Previous studies showed that (111)In-DOTA-ReCCMSH(Arg(11)), a cyclic analogue of alpha-melanocyte stimulating hormone (alpha-MSH), exhibited high tumor concentration and rapid clearance from nontarget tissue. The goal of this current study was to label DOTA-ReCCMSH(Arg(11)) with beta(+)-emitting radionuclides, to determine if the high sensitivity of positron emission tomography (PET) imaging would aid in the detection of malignant melanoma. DOTA-ReCCMSH(Arg(11)) was labeled with (64)Cu and (86)Y. Biodistribution and small animal PET imaging were carried out in mice implanted with B16/F1 murine melanoma tumor and compared with data obtained in the same animal model with [(18)F]FDG. In both cases a subset of animals were co-injected with 20 microg of DOTA-ReCCMSH(Arg(11)) to determine if tumor concentration was receptor mediated. Tumor concentration for both the (86)Y- and (64)Cu-complexes reached a maximum at 30 min, while coadministering 20 microg of unlabeled complex reduced tumor uptake significantly. Nontarget organ concentration was considerably lower with (86)Y-DOTA-ReCCMSH(Arg(11)) than its (64)Cu analogue, except in the kidneys, where the (64)Cu complex had lower accumulation at all time points. Small animal PET images for both complexes showed the tumor could be visualized after 30 min, with the standardized uptake value (SUV) analysis following a similar trend as the biodistribution data. The data obtained suggests that DOTA-ReCCMSH(Arg(11)), when labeled with beta(+)-emitting radionuclides, has the potential for early detection of malignant melanoma by exploiting the sensitivity and high resolution of PET.
 ...
PMID:Imaging of melanoma using 64Cu- and 86Y-DOTA-ReCCMSH(Arg11), a cyclized peptide analogue of alpha-MSH. 1582 37

We describe the computed tomography and F-18 FDG PET findings of a patient with extensive mediastinal nodal enlargement resulting from histoplasmosis. This patient with known metastatic melanoma presenting for restaging was initially considered to have widespread mediastinal and cervical metastases on the basis of the imaging findings. Bronchoalveolar lavage fluid and transbronchial lymph node biopsy were consistent with histoplasmosis. The imaging findings improved after treatment with antifungal medication. A relatively small area of pulmonary involvement proved to be the clue in the imaging studies that the disease was inflammatory rather than neoplastic.
 ...
PMID:Mediastinal histoplasmosis: F-18 FDG PET and CT findings simulating malignant disease. 1610 Apr 91

Metastatic mouse models of melanoma have been characterized by gross necropsy examination, histopathology, and optical imaging. To determine if the time progression, extent, and metabolism of melanoma metastases could be monitored noninvasively, serial micro-CT and small-animal PET imaging studies were performed by using a mouse model of melanoma. Juvenile female C57BL/6 mice were injected intravenously with syngenic B16-F10 melanoma cells. Serial micro-CT imaging studies were performed on anesthetized mice. Mice were necropsied at the development of adverse clinical signs or at postinjection Day 30, and tissues were collected for histopathology. In a separate study of four mice, tumor viability was assessed with 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) and studied by using small-animal PET imaging. A total of 59% of the mice developed metastatic tumors. Micro-CT image analysis was able to identify and follow up to 36% of metastatic lesions. Examples of metastatic lesions identified and followed up by micro-CT imaging included a lung metastasis, mandibular metastasis, subcutaneous metastasis, and tibial/femoral metastasis. Micro-CT and small-animal PET fusion imaging successfully correlated anatomic localization of glucose metabolism of the metastatic tumors. Micro-CT and small-animal PET imaging were found to be highly effective in detection and characterization of lesions produced by this metastatic melanoma model.
 ...
PMID:Microimaging characterization of a B16-F10 melanoma metastasis mouse model. 1695 24

This study aimed to detect metastases in patients with stage III or IV cutaneous melanoma by (18)F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT). Thirty-nine patients with clinically evident stage III or IV melanoma underwent whole-body FDG-PET/CT scans for metastatic disease and these results were compared with those of biopsy. Scans for 38 of the patients were evaluated; one patient's scan could not be evaluated. There were 11 true-positive, two false-positive, 24 true-negative and one false-negative scans for the detection of melanoma metastases, with sensitivity 91%, specificity 92%, accuracy 92%, and positive and negative predictive values 84% and 96%, respectively. False-positive FDG-PET/CT scans were due to sarcoidosis in the lung and infected cyst in the liver. It is concluded that FDG-PET/CT scanning has high sensitivity and specificity for detecting stage III or IV metastatic melanoma.
 ...
PMID:Detection of metastases in patients with cutaneous melanoma using FDG-PET/CT. 1769 33

We report the case of a 74-year-old man with metastatic melanoma of the small bowel. Melanoma metastasizing to the small bowel is a rare but well described presentation of the disease, detected clinically in only 2% to 5% of these patients. Its presentation is similar to other gastrointestinal tract tumors, with symptoms of abdominal pain or anemia prevailing. Recent studies have implicated the chemokine receptor CCR9 and its ligand CCL25 as signals that allow malignant melanoma cells to preferentially metastasize to the small bowel. Common imaging modalities used to detect these small bowel lesions include contrast-enhanced computed tomography (CT) scans and upper gastrointestinal series with small bowel follow-through. Given the low sensitivity of these modalities, newer helical CT scanners, 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET)/CT, and capsule endoscopy are now being recommended to replace the older imaging techniques. Current treatment modalities include surgical resection, which has been shown to increase overall survival, and adjuvant immunotherapy, whose efficacy is currently being questioned. A review of the current literature describing this rare occurrence is included to compare with our patient's presentation, diagnosis, and management.
 ...
PMID:A patient with metastatic melanoma of the small bowel. 1928 29

A 29-year-old woman presented with a new right supraclavicular mass on a background of resection of a malignant melanoma from her right shoulder before 4 years. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging revealed uptake in a right supraclavicular node and the inferior pole of the left lobe of the thyroid gland. Subsequent resection and histology of the right supraclavicular node and the left lobe of the thyroid gland demonstrated metastatic melanoma and palpation thyroiditis, respectively. A number of malignant and benign pathologies of the thyroid demonstrate FDG uptake, with 75% being benign. To our knowledge, the findings of palpation thyroiditis on FDG PET/CT have never been previously described.
 ...
PMID:Palpation thyroiditis seen on F-18 FDG PET/CT. 2128 97

This chapter discusses the value of FDG-PET and combined FDG-PET/CT in staging and follow-up of melanoma patients. For melanoma patients, the presence or absence of regional lymph node metastases is one of the most important prognostic factors; the recent development of sentinel lymph node biopsy offers a highly sensitive staging method. FDG-PET has shown a limited sensitivity to detect microscopic lymph node metastases in this selected group of patients with stages I and II melanoma. However, for the detection of distant metastases, FDG-PET is frequently used. Although there is no consensus, some surgeons pursue surgical excision of metastatic disease if only one or a few sites of disease are apparent. Precise identification of the location and number of metastatic lesions could therefore be important for surgical planning. Even though patients with metastatic melanoma generally have a poor prognosis (5-year survival 3-16%), there is still a need for accurate staging. Firstly, to identify those patients who may benefit from a surgical procedure, while avoiding these potentially harmful surgical procedures for patients with multiple distant metastases. Secondly, accurate staging is important to improve the efficiency of clinical trials, and thirdly, to provide patients with detailed information about their prognosis. Taking the published literature together, and reasoning that FDG-PET/CT is the current standard in PET imaging, there may be a case for the combined PET/CT in the setting of metastatic melanoma. However, further research is needed as the benefit of the combined FDG-PET/CT vs. FDG-PET alone seems to be less than reported for other tumor entities, which may be due to the high avidity of melanoma for FDG, so that many of the metastases are detected with FDG-PET and the additional CT does not increase the sensitivity.
 ...
PMID:Melanoma. 2133 32


1 2 3 4 5 Next >>