Usefulness of 18F-FDG PET/CT in Cutaneous Melanoma Patients with Negative Sentinel Lymph Nodes and High Clark Levels

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Abstract
We investigated the utility of PET/CT in cutaneous melanoma (CM) patients with pathological negative sentinel lymph nodes (SLN), within the first year. The results of PET/CTs and SLN biopsy (SLNB) in 65 patients (39 male and 26 female, mean age 53.8) with a PET/CT in the first postoperative year were evaluated. Within this cohort, the utility of early PET/CT imaging was assessed in patients with negative SLNB. McNemar test was used to compare PET/CT findings with SLNB results. Out of 43 patients with pathologically positive SLNs, 23 patients (53.5%) had positive and 20 patients (46.5%) had negative findings on PET/CT within the first postoperative year. On the other hand, PET/CT results of 22 patients with negative SLNBs were found to be negative in 19 patients (86.4%) and positive in 3 patients (13.6%). For the patients with negative SLNB results, the detection rate of distant metastasis with PET/CT was significantly lower (p<0.001) than that in patients with positive SLNBs. Our results showed that 18F-FDG PET/CT will most likely (86.4%) be negative during the first postoperative year in patients with a negative SLNB. Therefore, it is concluded that this modality would not provide any significant clinical contribution within this time frame.

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