PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma

Abstract

Background: Cutaneous malignant melanoma (CMM) is a highly aggressive tumor with high tendency of return despite complete surgical removal. It has a high risk of dissemination to regional lymph nodes and visceral organs. The prognosis is highly dependent on lymph node involvement and distant metastases. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. The purpose of the present study was to evaluate the role of integrated (PET/CT) in staging, restaging, prognosis, and prediction of recurrence in patients with malignant melanoma. Results: Fifty malignant melanoma patients with age ranged from 28 to74 years (mean age 55.94 + 13.40 years) were 28 males (mean age 56.71 + 12.82) and 22 females (mean age 54.95 + 14.34). All our patients were histopathologically proven to have malignant melanoma. Twenty-one patients came for initial staging by 18F-FDG PET/CT. Their findings were compared with the reference standards and showed the sensitivity of 93.33%, specificity of 60%, and accuracy of 85.71% for primary staging. 18F-FDG PET/CT scan in 11 clinical suspicion patients of relapse after treatment showed the sensitivity of 100%, specificity of 66.66%, positive predictive value of 88.88%; negative predictive value of 100%; and accuracy of 90.90%. FDG-PET/CT of whole body scan in 18 cases of stage IV melanoma showed sensitivity of 100%, specificity of 66.66%, and overall accuracy of 94.44% for detection of distant metastases. SUVmean and SUVmax in all studied groups were significantly higher in true positive more than true negative or false-positive patients diagnosed by PET/CT with high sensitivity (82.88-100%). Conclusion: PET/CT imaging enhanced diagnostic performance in detection of the primary malignancy, in followup of high-risk patients and patients with suspected or known local or distant recurrence, and in restaging of patients with known distant metastatic disease to assess tumor response.

Diagnostic Performance of [18F]F-FDG Positron Emission Tomography (PET) in Non-Ophthalmic Malignant Melanoma: A Systematic Review and Meta-Analysis of More Than 10,000 Melanoma Patients

“…During the full text review of the remaining 372 articles, 269 were considered ineligible based on the above-mentioned selection criteria. Finally, 100 studies [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ...…”

“… Forest plots for the pooled sensitivity and specificity calculation for initial staging at the patient level. Horizontal lines represent 95% confidence intervals of the individual studies [ 13 , 14 , 15 , 20 , 21 , 22 , 24 , 27 , 28 , 33 , 35 , 36 , 40 , 44 , 46 , 49 , 52 , 53 , 58 , 62 , 63 , 64 , 67 , 73 , 74 , 84 , 85 , 86 , 89 , 90 , 95 , 99 , 100 , 102 , 103 , 107 , 109 ]. …”

Prognostic Value of Baseline 18F-FDG PET/CT to Predict Brain Metastasis Development in Melanoma Patients

“…Additionally, they retained their significance after the exclusion of patients with primary non-cutaneous disease. Thus, the characteristics of lymph nodes may have prognostic implications, especially considering that melanoma prognosis is closely tied to lymph node involvement [ 5 ]. The most common site (almost 75%) of metastases is regional lymph nodes, serving as an early indicator of distant involvement potential [ 12 , 36 , 37 ].…”

“…Skin cancer is the most commonly diagnosed cancer type worldwide [ 1 ]. Malignant melanoma, an aggressive, highly metastatic malignancy, has the highest mortality rate among all skin-related malignancies, imposing a healthcare burden and cost, particularly in advanced stages [ 2 , 3 , 4 , 5 ]. Thus, it is a challenge in global public health and has been shown to have a continuous increase in incidence during the last 50 years, particularly in fair-skinned populations [ 1 , 4 ].…”

Rola techniki PET/CT w ocenie czerniaka złośliwego

“…Zdaniem autorów [13][14][15], badanie 18 F-FDG PET/CT znajduje zastosowanie w ocenie przerzutów odległych czerniaka złośliwego zarówno w procesie kwalifikacji do leczenia, jak i ewaluacji skuteczności terapii. Czułość i swoistość metody 18 F-FDG PE/CT w ocenie ognisk odległych wynosi, odpowiednio, 86%, 91% [13], a ocenie skuteczności leczenia -89%, 92% [14]. Czułość i swoistość badania zależeć może jednak nie tylko od typu schorzenia onkologicznego, ale także od regionu poddawanego skanowaniu.…”