alexa Capsule endoscopy versus positron emission tomography for detection of small-bowel metastatic melanoma: a pilot study.


Journal of Gastrointestinal & Digestive System

Author(s): Prakoso E, Fulham M, Thompson JF, Selby WS

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Abstract BACKGROUND: Melanoma is the most common tumor to metastasize to the GI tract, where it mainly involves the small bowel. OBJECTIVE: To compare capsule endoscopy (CE) and (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT scanning, the current standard and most sensitive investigation modality, in detecting small-bowel metastases in patients with metastatic melanoma. DESIGN: A prospective study of patients with metastatic melanoma who were undergoing FDG PET-CT scanning. CE was performed and the results read by two independent observers without knowledge of the other investigation results. SETTING: Tertiary care centers. PATIENTS: This study involved 21 patients with a median age of 52 years (range 22-88 years). INTERVENTION: CE. MAIN OUTCOME MEASUREMENTS: Detection of small-bowel melanoma. RESULTS: FDG PET-CT scanning showed increased abdominal uptake in 12 patients, but only 5 of these patients were found to have small-bowel melanoma on CE. Importantly, in 1 patient with a bleeding small-bowel tumor on CE, the FDG PET-CT scan result was negative. One patient with positive FDG PET-CT scan results and negative CE results subsequently developed symptomatic small-bowel melanoma 10 months after CE. LIMITATIONS: Small-bowel melanoma could not be excluded entirely in 7 patients with positive FDG PET-CT scan results and negative CE results, and follow-up is ongoing. The number of patients in this study was small. CONCLUSION: CE was better than FDG PET-CT scanning in localizing small-bowel melanoma. This study suggests that CE is an ideal complementary investigation modality for patients with known metastatic melanoma undergoing preoperative work-ups and in those with unexplained anemia or GI symptoms. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. This article was published in Gastrointest Endosc and referenced in Journal of Gastrointestinal & Digestive System

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