European Radiology

, Volume 27, Issue 6, pp 2538–2545 | Cite as

Imaging of gastrointestinal melanoma metastases: Correlation with surgery and histopathology of resected specimen

  • Ahmed E. Othman
  • Thomas K. Eigentler
  • Georg Bier
  • Christina Pfannenberg
  • Hans Bösmüller
  • Christian Thiel
  • Claus Garbe
  • Konstantin Nikolaou
  • Bernhard Klumpp
Oncology

Abstract

Objective

To assess the appearance of gastrointestinal melanoma metastases on CT and PET/CT and evaluate the diagnostic value of CT and PET/CT compared with surgery and histopathology.

Methods

We retrospectively included 41 consecutive patients (aged 56.1 ± 13.5 years) with gastrointestinal melanoma metastases who underwent preoperative imaging (CT: all, PET/CT: n = 24) and metastasectomy. Two blinded radiologists assessed CT and PET/CT for gastrointestinal metastases and complications. Diagnostic accuracy and differences regarding lesion detectability and complications were assessed, using surgical findings and histopathology as standard of reference.

Results

Fifty-three gastrointestinal melanoma metastases (5.0 ± 3.8 cm) were confirmed by surgery and histopathology. Lesions were located in the small bowel (81.1 %), colon (15.1 %) and stomach (3.8 %), and described as infiltrating (30.2 %), polypoid (28.3 %), cavitary (24.5 %) and exoenteric (17.0 %). Fifteen patients (37 %) had gastrointestinal complications. Higher complication rates were associated with large and polypoid lesions (p ≤ .012). Diagnostic accuracy was high for CT and PET/CT (AUC ≥ .802). For reader B (less experienced), CT yielded lower diagnostic accuracy than PET/CT (p = .044).

Conclusion

Most gastrointestinal melanoma metastases were located in the small bowel. Large and polypoid metastases were associated with higher complication rates. PET/CT was superior for detection of gastrointestinal melanoma metastases and should be considered in patients with limited disease undergoing surgery.

Key Points

Gastrointestinal melanoma metastases (GI-MM) are rare but often cause serious gastrointestinal complications.

Early detection of GI-MM is important to prevent complications and guide surgery.

PET/CT is superior to CT for detection of GI-MMs.

PET/CT should be considered for patients with limited disease before surgical resection.

Keywords

Melanoma Gastrointestinal metastases PET/CT CT Computed tomography 

Abbreviations

95 % CI

95 % confidence interval

AUC

Area under the curve

CT

Computed tomography

GI-MM

Gastrointestinal melanoma metastasis

HR

High resolution

MPR

Multiplanar reconstruction

PET

Positron emission tomography

ROC

Receiver operator characteristic

Notes

Acknowledgments

The scientific guarantor of this publication is PD Dr. Bernhard Klumpp. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors (Ahmed E. Othman) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board.

Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Ahmed E. Othman
    • 1
  • Thomas K. Eigentler
    • 2
  • Georg Bier
    • 1
  • Christina Pfannenberg
    • 1
  • Hans Bösmüller
    • 3
  • Christian Thiel
    • 4
  • Claus Garbe
    • 2
  • Konstantin Nikolaou
    • 1
  • Bernhard Klumpp
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyEberhard Karls University Tuebingen, University Hospital TuebingenTuebingenGermany
  2. 2.Department of DermatologyEberhard Karls University Tuebingen, University Hospital TuebingenTuebingenGermany
  3. 3.Institute of PathologyEberhard Karls University Tuebingen, University Hospital TuebingenTuebingenGermany
  4. 4.Department of General, Visceral and Transplantation SurgeryEberhard Karls University Tuebingen, University Hospital TuebingenTuebingenGermany

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