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Role of Nuclear Medicine in the Management of Cutaneous Malignant Melanoma^*

¹ Department of Diagnostic Radiology and Nuclear Medicine, St. Joseph's Hospital, London, Ontario, Canada; ² Centre for PET and Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, Victoria, Australia; ³ Department of Nuclear Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and ⁴ Department of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, California

Correspondence: For correspondence or reprints contact: Tarik Z. Belhocine, MD, PhD, Department of Diagnostic Radiology and Nuclear Medicine, St. Joseph's Hospital–Lawson Health Sciences Center, 268 Grosvenor St., London, Ontario 6NA 4V2, Canada. E-mail: tarikbelhocine{at}yahoo.fr

Malignant melanoma of the skin is one of the most lethal cancers. The disease may spread either locally or regionally and to distant sites through predictable or unpredictable metastatic pathways. Accurate staging and restaging of disease are required for appropriate treatment decision making. Routine protocols based on clinical examinations and traditional radiologic evaluations are not cost-effective for the detection of systemic disease. In the last decade, nuclear medicine techniques, such as lymphoscintigraphy-directed lymphatic mapping and sentinel lymphadenectomy and ¹⁸F-FDG PET, have played key roles in nodal and distant staging of melanoma. More recently, anatomic–functional imaging has been improved with the development of integrated PET/CT devices or combined SPECT/CT systems. ¹⁸F-FDG–sensitive intraoperative probes have been specifically designed to detect small nodal and visceral metastases from melanoma and may become important tools for the cancer surgeon. In this article, we review the role of nuclear medicine in the assessment of malignant melanoma.

Key Words: LM/SL • SPECT/CT • ¹⁸F-FDG PET • PET/CT • ¹⁸F-FDG–sensitive probe