Imaging of gastrointestinal melanoma metastases: Correlation with surgery and histopathology of resected specimen
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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.
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.
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).
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.
• 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.
KeywordsMelanoma Gastrointestinal metastases PET/CT CT Computed tomography
- 95 % CI
95 % confidence interval
Area under the curve
Gastrointestinal melanoma metastasis
Positron emission tomography
Receiver operator characteristic
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.
- 1.Balch CM (1992) Cutaneous melanoma: prognosis and treatment results worldwide. In: Seminars in surgical oncology (pp. 400-414). John Wiley & Sons, Inc., New JerseyGoogle Scholar
- 15.Schwimmer J, Essner R, Patel A, Jahan S (2000) A review of the literature for whole-body FDG PET in the management of patients with melanoma. Q J Nucl Med Mol Imaging 44:153Google Scholar