Info

PPV: 90% Stage III

SNB, sentinel node biopsy.

SNB, sentinel node biopsy.

Rinne et al.370 examined 48 patients with clinical or CT findings suggesting local or distant metastatic disease, and FDG-PET was found to be 92% sensitive, 95% specific, and 93% accurate, compared with 58%, 45%, and 56% for sensitivity, specificity, and accuracy, respectively, for CT.

Eigtved et al.371 confirmed the superiority of FDG-PET in a study of 38 patients with either local recurrence, in-transit recurrence, regional lymph node metastases, or distant metastases, with sensitivity and specificity of 97% and 56%, respectively, compared with 62% and 22% for conventional imaging.

It is obvious now that PET is indeed superior for localization of distant metastases outside of the lungs and brain, independent of the particular stage of the high-risk patient. Swetter et al.,372 in a study of 104 patients, reported a sensitivity and specificity for PET of 84% and 97% and for CT of 58% and 70%, respectively, for the detection of metastatic disease.

Gulec et al.373 studied 49 patients and found that FDG-PET identified more metastatic sites in 55% of the patients and changed the management in 49% of them. Dietlein et al.374 and Krug et al.375 reported that FDG-PET was inferior in the detection of pulmonary and liver metastases, but these studies suffered from various methodologic weaknesses. Distant metastases can be identified by FDG-PET either in patients with locoregional disease or in patients with known distant lesions, and these findings can change their clinical management.

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