Detection of unsuspected spinal cord compression in melanoma patients by 18F-fluorodeoxyglucose—positron emission tomography

• Published in: European journal of surgical oncology 2005-03, Vol.31 (2), p.197-204
• Main Authors: Francken, A.B., Hong, A.M., Fulham, M.J., Millward, M.J., McCarthy, W.H., Thompson, J.F.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cervical Vertebrae - pathology; Cervical Vertebrae - radiation effects; Cervical Vertebrae - surgery; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Melanoma; Melanoma - diagnosis; Melanoma - therapy; Metastases; Middle Aged; Positron emission tomography; Radiopharmaceuticals; Radiotherapy; Spinal cord compression; Spinal Cord Compression - diagnosis; Spinal Cord Compression - therapy; Spinal Cord Neoplasms - diagnosis; Spinal Cord Neoplasms - therapy; Surgical Procedures, Operative; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2004.08.009

Positron emission tomography (PET) using 18F-fluorodeoxyglucose can detect early or small metastatic deposits of melanoma and guide subsequent correlative anatomical imaging and treatment. The aim of this study was to assess the value of PET in demonstrating spinal cord compression by otherwise unsuspected metastatic disease. Reports of 1365 PET studies performed on patients with melanoma were reviewed. Fifty patients considered to be at risk of spinal cord compression on the basis of PET were identified and 35 patients were analysed. Magnetic resonance imaging and computed tomography were used to confirm or refute the diagnosis. The symptoms and signs at the time of PET and follow-up status were compared between patients with and without confirmed spinal cord compression. In nine patients (26%) compression of the spinal cord or adjacent neurological structures was confirmed and eight of these patients had immediate treatment. Survival was poor in both patient groups, but three patients with confirmed compression maintained good neurological functional status following treatment. PET can detect imminent, unsuspected spinal cord compression in patients with metastatic melanoma. Immediate anatomical imaging of the spine is recommended in patients who have evidence of spinal cord compression on PET.