Whole-Body Positron Emission Tomography: An Accurate Staging Modality for Metastatic Melanoma

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Abstract
We read with interest the study by Blessing et al1 assessing the value of fluorodeoxyglucose positron emission tomography and ultrasonography in detecting lymph node metastasis in patients with melanoma. The correct diagnosis of metastatic involvement of lymph nodes is a known challenge to the radiologist and clinician. Diagnosis of a lymph node metastasis using cross-sectional imaging modalities, ie, computed tomography and magnetic resonance imaging, is mainly based on size, choosing 1 to 1.5 cm as a cut-off value between benign and pathologic lymph nodes. However, using these criteria, micrometastases in small lymph nodes can be missed and reactively enlarged lymph nodes can cause false-positive results, limiting the value of the meth