Evidence map›Paper›PMID 29876618›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2018

Can integrated 18F-FDG PET/MR replace sentinel lymph node resection in malignant melanoma?

Benedikt Michael Schaarschmidt, Johannes Grueneisen, Vanessa Stebner, Joachim Klode, Ingo Stoffels, Lale Umutlu, Dirk Schadendorf, Philipp Heusch, Gerald Antoch, Thorsten Dirk Pöppel

Abstract readComparative StudyEvaluation Study
PubMed Publisher
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.1field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 20 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. Value ofCancer management and research · 2021
    Article
  9. Imaging of pediatric cutaneous melanoma.Pediatric radiology · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Benedikt Michael SchaarschmidtMedical Faculty, Department of Diagnostic and Interventional Radiology, Univ Dusseldorf, Dusseldorf, Germany. benedikt.schaarschmidt@uk-essen.de.
Johannes GrueneisenMedical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Univ Duisburg-Essen, Essen, Germany.
Vanessa StebnerMedical Faculty, Department of Nuclear Medicine, Univ Duisburg-Essen, Essen, Germany.
Joachim KlodeDepartment of Dermatology, Venerology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Ingo StoffelsDepartment of Dermatology, Venerology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Lale UmutluMedical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Univ Duisburg-Essen, Essen, Germany.
Dirk SchadendorfDepartment of Dermatology, Venerology and Allergology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Philipp HeuschMedical Faculty, Department of Diagnostic and Interventional Radiology, Univ Dusseldorf, Dusseldorf, Germany.
Gerald AntochMedical Faculty, Department of Diagnostic and Interventional Radiology, Univ Dusseldorf, Dusseldorf, Germany.
Thorsten Dirk PöppelMedical Faculty, Department of Nuclear Medicine, Univ Duisburg-Essen, Essen, Germany.
University of Duisburg-Essen · DEDeutschen Konsortium für Translationale Krebsforschung · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare the sensitivity and specificity of 18F-fluordesoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), 18F-FDG PET/magnetic resonance (18F-FDG PET/MR) and 18F-FDG PET/MR including diffusion weighted imaging (DWI) in the detection of sentinel lymph node metastases in patients suffering from malignant melanoma. MATERIAL &

methodsFifty-two patients with malignant melanoma (female: n = 30, male: n = 22, mean age 50.5 ± 16.0 years, mean tumor thickness 2.28 ± 1.97 mm) who underwent 18F-FDG PET/CT and subsequent PET/MR & DWI for distant metastasis staging were included in this retrospective study. After hybrid imaging, lymphoscintigraphy including single photon emission computed tomography/CT (SPECT/CT) was performed to identify the sentinel lymph node prior to sentinel lymph node biopsy (SLNB). In a total of 87 sentinel lymph nodes in 64 lymph node basins visible on SPECT/CT, 17 lymph node metastases were detected by histopathology. In separate sessions PET/CT, PET/MR, and PET/MR & DWI were assessed for sentinel lymph node metastases by two independent readers. Discrepant results were resolved in a consensus reading. Sensitivities, specificities, positive predictive values and negative predictive values were calculated with histopathology following SPECT/CT guided SLNB as a reference standard.

resultsCompared with histopathology, lymph nodes were true positive in three cases, true negative in 65 cases, false positive in three cases and false negative in 14 cases in PET/CT. PET/MR was true positive in four cases, true negative in 63 cases, false positive in two cases and false negative in 13 cases. Hence, we observed a sensitivity, specificity, positive predictive value and negative predictive value of 17.7, 95.6, 50.0 and 82.3% for PET/CT and 23.5, 96.9, 66.7 and 82.3% for PET/MR. In DWI, 56 sentinel lymph node basins could be analyzed. Here, the additional analysis of DWI led to two additional false positive findings, while the number of true positive findings could not be increased.

conclusionIn conclusion, integrated 18F-FDG PET/MR does not reliably differentiate N-positive from N-negative melanoma patients. Additional DWI does not increase the sensitivity of 18F-FDG PET/MR. Hence, sentinel lymph node biopsy cannot be replaced by 18F-FDG-PE/MR or 18F-FDG-PET/CT.

Indexed as

AdultAgedFalse Negative ReactionsFemaleFluorodeoxyglucose F18HumansLymphatic MetastasisMagnetic Resonance ImagingMaleMelanomaMiddle AgedMultimodal ImagingPositron Emission Tomography Computed TomographyRadiopharmaceuticalsSentinel Lymph NodeSentinel Lymph Node BiopsyFluorodeoxyglucose F18RadiopharmaceuticalsDWIMalignant melanomaMMMRIPET/CTPET/MRI

Identifiers

PMID29876618
OpenAlexW2805412047

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.