Magnetic resonance spectroscopy in the management of melanoma

The surgical treatment of melanoma has been progressively rationalised during the last two decades. Radical excision of primary tumours and elective (prophylactic) resection of regional lymph nodes have been replaced with more selective procedures that reflect improved understanding of the metastatic potential of individual tumours. Magnetic resonance spectroscopy (MRS) is an evolving technology which has the potential to diagnose many tumours and to characterise their metastatic potential. The Institute for Magnetic Resonance Research and the Sydney Melanoma Unit have developed MRS techniques to diagnose, stage and aid in the clinical management of melanoma. It is anticipated that these techniques will ultimately be used as clinical tools to provide non-surgical diagnosis of metastatic disease in sentinel nodes, either by MRS examination of a simple outpatient fine needle biopsy specimen or by use of an entirely non-invasive in vivo MRS assessment. Experience with MRS of primary breast cancers indicates that it may also be possible to predict the metastatic potential of melanoma by spectroscopic analysis of the primary tumour and to distinguish naevi from melanomas thus better selecting patients for surgery