18Fluoro2deoxy-Dglucose-Positron Emission Tomography (FDG-PET) Imaging versus sentinel lymph node biopsy (SLNB) in the staging of cutaneous melanoma in AJCC stage i and II.

Aim. In the present study, 18Fluoro-2-deoxy-D-Glucose-Positron Emission Tomography (FDG-PET) findings were compared with histopathological results of sentinel lymph-node biopsy (SNLB). The purpose was to determine the value of FDG-PET in predicting regional lymph-node involvement in patients with primary melanoma stage I and II. Methods. Twenty five consecutive patients with primary cutaneous melanoma, stage I and II, underwent FDG-PET scans, preoperative lymphoscintigraphy, and SNLB. The sentinel node detection was sistematically performed within the week following the PET scanning. Results. The FDG-PET and SNLB results were interpreted independently of each other and then compared. Conclusions. SNLB remains the technique of choise for evaluating the histological status of lymph-node basins and is the only reliable method for identifying micrometastatic disease in the regional draining node; FDG-PET appears insufficiently sensitive to identify microscopic nodal metastases and cannnot be expected to give additional information of stage I-II patients. Based on our results and data from literature, the Authors not recommend 18-FDG-PET as a first line imaging strategy for staging with a AJCC stage I or II primary disease.