Clinical

Abdominal CT rarely identifies hepatic metastases from uveal melanoma

Last Updated: 2010-03-10 19:30:12 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Abdominal CT scan seldom detects hepatic metastases from uveal melanoma and may not be indicated for screening, according to a report in the March Archives of Ophthalmology.

"An abnormal CT scan of the liver in a newly diagnosed uveal melanoma patient is 10-15 times more likely to be non-neoplastic than metastasis," senior author Dr. David H. Abramson from Memorial Sloan-Kettering Cancer Center, New York, told Reuters Health by email.

Dr. Abramson and colleagues reviewed CT scans obtained in 91 patients within 1 month (mean, 8 days) of being diagnosed with uveal melanoma.

Fifty patients (55%) had an abnormality on the abdominal CT, but only 3 (3.3%) had confirmed hepatic metastases.

Lesions were more likely to be multiple than solitary in scans that were "suspicious for metastasis," but neither the CT protocol (triphasic or nontriphasic) nor the center where the scan was done (Memorial Sloan-Kettering or elsewhere) distinguished normal and abnormal readings.

"It is important to acknowledge the possibility that the lesions classified at the initial CT as too small to characterize may have been metastatic melanomas that went undetected," the investigators caution. "Therefore, the 3.3% value may underestimate the incidence of metastatic disease in these patients."

The researchers note that a randomized trial would validate their findings. In the meantime, Dr. Abramson said, "Based on our study we have moved away from CT scans of the liver for screening. We encourage others to look at their results."

Arch Ophthalmol 2010;128:319-323.