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Imaging of gastrointestinal melanoma metastases: Correlation with surgery and histopathology of resected specimen.
- Source :
-
European radiology [Eur Radiol] 2017 Jun; Vol. 27 (6), pp. 2538-2545. Date of Electronic Publication: 2016 Oct 17. - Publication Year :
- 2017
-
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.<br />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.<br />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).<br />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.<br />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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Colonic Neoplasms pathology
Colonic Neoplasms secondary
Colonic Neoplasms surgery
Female
Gastrointestinal Neoplasms secondary
Gastrointestinal Neoplasms surgery
Humans
Intestine, Small pathology
Male
Melanoma secondary
Melanoma surgery
Middle Aged
Multimodal Imaging
Observer Variation
Positron Emission Tomography Computed Tomography methods
Positron-Emission Tomography methods
Preoperative Care
Retrospective Studies
Sensitivity and Specificity
Stomach Neoplasms pathology
Stomach Neoplasms secondary
Stomach Neoplasms surgery
Tomography, X-Ray Computed methods
Gastrointestinal Neoplasms pathology
Melanoma pathology
Skin Neoplasms
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 27
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27752834
- Full Text :
- https://doi.org/10.1007/s00330-016-4625-7