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Tumour assessment in advanced melanoma: value of FDG-PET/CT in patients with elevated serum S-100B

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the usefulness of PET/CT in melanoma patients with an elevated serum S-100B tumour marker level.

Methods

Out of 165 consecutive high-risk melanoma patients referred for PET/CT imaging, 47 had elevated (>0.2 μg/l) S-100B serum levels and a contemporaneous 18F-FDG PET/CT scan. PET/CT scans were evaluated for the presence of metastases. To produce a composite reference standard, we used cytological, histological, MRI and PET/CT follow-up findings as well as clinical and S-100B follow-up.

Results

Among the 47 patients with increased S-100B levels, PET/CT correctly identified metastases in 38 (30 distant metastases and eight lymph node metastases). In one patient with cervical lymph node metastases, PET/CT was negative. Eight patients had no metastases and PET/CT correctly excluded metastases in all of them. Overall sensitivity for metastases was 97% (38/39), specificity 100% (8/8) and accuracy 98% (46/47). S-100B was significantly higher in patients with distant metastases (mean 1.93 μg/l, range 0.3–14.3 μg/l) than in patients with lymph node metastases (mean 0.49 μg/l, range 0.3–1.6 μg/l, p = 0.003) or patients without metastases (mean 0.625 μg/l, range 0.3–2.6 μg/l, p = 0.007). However, 6 of 14 patients with a tumour marker level of 0.3 μg/l had no metastases.

Conclusion

In melanoma patients with elevated S-100B tumour marker levels, FDG-PET/CT accurately identifies lymph node or distant metastases and reliably excludes metastases. Because of the significant number of false positive S-100B tumour marker determinations (17%), we recommend repetition of tumour marker measurements if elevated S-100B levels occur before extensive imaging is used.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Klaus Strobel, Victor Kalff & Hans C. Steinert

  2. Department of Dermatology, University Hospital Zurich, Zurich, Switzerland

    Jeannine Skalsky, Katrin Baumann & Reinhard Dummer

  3. Department of Nuclear Medicine, Alfred Hospital Melbourne, Melbourne, Australia

    Victor Kalff

  4. Institute of Biostatistics, University of Zurich, Zurich, Switzerland

    Burkhardt Seifert

  5. Department of Immunology, University Hospital Zurich, Zurich, Switzerland

    Helen Joller-Jemelka

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  1. Klaus Strobel
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  2. Jeannine Skalsky
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  3. Victor Kalff
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  4. Katrin Baumann
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Correspondence to Klaus Strobel.

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Strobel, K., Skalsky, J., Kalff, V. et al. Tumour assessment in advanced melanoma: value of FDG-PET/CT in patients with elevated serum S-100B. Eur J Nucl Med Mol Imaging 34, 1366–1375 (2007). https://doi.org/10.1007/s00259-007-0403-8

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  • DOI: https://doi.org/10.1007/s00259-007-0403-8

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