[Role of FDG PET-CT in cutaneous melanoma]

The indications of FDG PET-CT are well established for some neoplasms, such as lung cancer and lymphoma. The role of FDG PET-CT for the management of cutaneous melanoma is less clear.

We successively describe the substances and machines used with PET-CT, and review the French recommendations and the latest scientific articles to determine which patients could benefit from this examination.

PET-CT is not indicated for the diagnosis of the malignancy of a suspicious cutaneous lesion, or for initial regional node staging. PET-CT is not indicated for the initial staging of melanoma without node involvement. PET-CT could be proposed for the staging of thick melanoma with macroscopic involvement of the sentinel node. PET-CT is useful for distant staging. The sole curative treatment of melanoma being surgery, the most useful indications of PET-CT are preoperative staging of one (or more) nodal or distant metastases, whether histologically confirmed or not. Preoperative PET-CT can spare a patient with unknown metastases a useless surgery. PET-CT is not indicated for the staging of a patient with known inoperable metastatic disease. PET-CT is not indicated for assessing response to chemotherapy, except in clinical trials.