American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which imaging technique is used during stage 4 melanoma follow-up?

1. MRI brain

2. X-ray

3. CT A/P PET

4. Ultrasound

The correct answer is: CT A/P PET

In the follow-up of stage 4 melanoma, the most comprehensive imaging technique used is the combination of CT abdomen/pelvis along with PET, often referred to as CT A/P PET. This method is essential for evaluating the presence of metastatic disease, which is crucial in a patient with advanced melanoma. Stage 4 melanoma indicates that the cancer has spread beyond its original site to distant regions of the body. As such, monitoring for potential metastatic lesions is important to guide treatment decisions and assess prognosis. CT scans provide detailed images of the body's internal structures, allowing for the identification of tumors in the abdomen, pelvis, and other areas. When combined with PET imaging, which highlights areas of increased metabolic activity often associated with cancer, this dual modality significantly enhances the detection of metastases. In contrast, other imaging modalities such as MRI of the brain, X-ray, or ultrasound may be utilized in specific scenarios but do not offer the same level of comprehensive evaluation for metastatic disease that CT A/P PET provides. MRI is primarily focused on brain assessment, X-ray is limited in scope and sensitivity for soft tissue evaluations, and ultrasound is often reserved for surface-level assessments or certain specific applications. Thus, CT A/P PET remains the gold standard in the follow-up imaging for