Fluorodeoxyglucose-positron emission tomography imaging versus sentinel node biopsy in the primary staging of melanoma patients

Background. Positron emission tomography (PET) imaging is superior to conventional techniques for the evaluation of patients with stage III and stage IV cutaneous-melanoma. Several studies have highlighted the advantages of this noninvasive technique for the assessment of lymph node involvement. Objective. To compare PET imaging with sentinel node biopsy for primary staging of cutaneous melanoma and to discuss the technical limitations of PET scanning. Methods. Twenty-five consecutive patients with a histologic diagnosis of melanoma with a Breslow thickness equal or greater to 1 mm underwent a preoperative PET to assess lymph node involvement. Results. Sentinel node biopsy and PET showed a sensitivity of 100% and 22%, respectively, in the identification of lymph node metastases. Conclusion. PET is not a sensitive technique for the primary staging of cutaneous melanoma.