The Role and Potential of 18F-FDG PET/CT in Malignant Melanoma: Prognostication, Monitoring Response to Targeted and Immunotherapy, and Radiomics

Filippi, Luca; Bianconi, Francesco; Schillaci, Orazio; Spanu, Angela; Palumbo, Barbara

doi:10.3390/diagnostics12040929

Cited by 20 publications

(21 citation statements)

References 78 publications

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“…Therefore, it provides mechanistic insights concerning tumor heterogeneity and prognosis and identifies instances of treatment failure in various tumors, including skin cancer. It is also worth mentioning that PET remains the most popular technique for advanced CM staging and therapy response evaluation [ 232 ]. Table 1 depicts the advantages and limitations of the PET technique compared with other imaging techniques available for skin cancer imaging.…”

Section: Molecular Imaging Techniquesmentioning

confidence: 99%

Skin Cancer Pathobiology at a Glance: A Focus on Imaging Techniques and Their Potential for Improved Diagnosis and Surveillance in Clinical Cohorts

Dobre

Surcel

Constantin

et al. 2023

IJMS

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Early diagnosis is essential for completely eradicating skin cancer and maximizing patients’ clinical benefits. Emerging optical imaging modalities such as reflectance confocal microscopy (RCM), optical coherence tomography (OCT), magnetic resonance imaging (MRI), near-infrared (NIR) bioimaging, positron emission tomography (PET), and their combinations provide non-invasive imaging data that may help in the early detection of cutaneous tumors and surgical planning. Hence, they seem appropriate for observing dynamic processes such as blood flow, immune cell activation, and tumor energy metabolism, which may be relevant for disease evolution. This review discusses the latest technological and methodological advances in imaging techniques that may be applied for skin cancer detection and monitoring. In the first instance, we will describe the principle and prospective clinical applications of the most commonly used imaging techniques, highlighting the challenges and opportunities of their implementation in the clinical setting. We will also highlight how imaging techniques may complement the molecular and histological approaches in sharpening the non-invasive skin characterization, laying the ground for more personalized approaches in skin cancer patients.

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Section: Molecular Imaging Techniquesmentioning

confidence: 99%

Skin Cancer Pathobiology at a Glance: A Focus on Imaging Techniques and Their Potential for Improved Diagnosis and Surveillance in Clinical Cohorts

Dobre

Surcel

Constantin

et al. 2023

IJMS

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“…In the study of Won-Ik Cho et al, the threshold of maximum standardized uptake value (SUVmax) was 4.25 to differentiate malignant and benign VCFs, with 85% sensitivity and 71% speci city for malignancy [13]. Besides, many quantitative metabolic parameters of PET/CT such as the peak of standardized uptake value(SUVpeak), lean body mass correction of SUV(SUL), metabolic tumor volume(MTV), total lesion glycolysis(TLG) had been widely used in the diagnosis, treatment and prognosis assessment of lung cancer, colorectal cancer, malignant melanoma and other diseases [14][15][16][17][18]. The studies on the multiple metabolic parameters of PET/CT to distinguish benign and malignant VCFs are few.…”

Section: Introductionmentioning

confidence: 99%

Value of 18F-FDG-PET/CT radiomics combined clinical variables in differential diagnosis of malignant and benign vertebral compression fractures

Zhou

et al. 2023

Preprint

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Background Vertebral compression fractures (VCFs) are common clinical problems that can be caused by various reasons. The differential diagnosis of benign and malignant VCFs is challengeable. This study aimed to develop and validate a radiomics model to predict benign and malignant VCFs on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT). Results Twenty-six features (9 PET features and 17 CT features) and five clinical variables (age, SUVmax, SUVpeak, SULmax, SULpeak) were selected ultimately. The area under the curve (AUC) of the radiomics and clinical-radiomics model were statistically different from the clinical model in both training group (0.986, 0.987 vs. 0.884, p < 0.05) and test group (0.962, 0.948 vs. 0.858, p < 0.05), while there was no significant difference between the radiomics model and clinical-radiomics model (p > 0.05). The accuracy of the radiomics and clinical-radiomics model was 94%, 95.0% in training group and 93.2%, 93.2% in test group. Three models all showed good calibration (Hosmer_Lemeshow_test, p > 0.05). According to the decision curve analysis (DCA), the radiomics model and clinical-radiomics model showed higher overall net benefit than the clinical model. Conclusions The PET/CT-based radiomics and clinical-radiomics model showed good performance in distinguishing between malignant and benign VCFs. The radiomics method may be valuable for treatment decision-making.

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“…Melanoma is the fifth leading cancer diagnosis [ 1 ], and the therapy for late-stage metastatic melanoma changed with the approval of checkpoint-inhibitor therapy (CIT), leading to a 5-year survival rate of more than 50% [ 2 , 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a Hybrid-Imaging-Based Prognostic Index for Metastasized-Melanoma Patients in Whole-Body 18F-FDG PET/CT and PET/MRI Data

Küstner¹,

Vogel²,

Hepp³

et al. 2022

Diagnostics

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Besides tremendous treatment success in advanced melanoma patients, the rapid development of oncologic treatment options comes with increasingly high costs and can cause severe life-threatening side effects. For this purpose, predictive baseline biomarkers are becoming increasingly important for risk stratification and personalized treatment planning. Thus, the aim of this pilot study was the development of a prognostic tool for the risk stratification of the treatment response and mortality based on PET/MRI and PET/CT, including a convolutional neural network (CNN) for metastasized-melanoma patients before systemic-treatment initiation. The evaluation was based on 37 patients (19 f, 62 ± 13 y/o) with unresectable metastasized melanomas who underwent whole-body 18F-FDG PET/MRI and PET/CT scans on the same day before the initiation of therapy with checkpoint inhibitors and/or BRAF/MEK inhibitors. The overall survival (OS), therapy response, metastatically involved organs, number of lesions, total lesion glycolysis, total metabolic tumor volume (TMTV), peak standardized uptake value (SULpeak), diameter (Dmlesion) and mean apparent diffusion coefficient (ADCmean) were assessed. For each marker, a Kaplan–Meier analysis and the statistical significance (Wilcoxon test, paired t-test and Bonferroni correction) were assessed. Patients were divided into high- and low-risk groups depending on the OS and treatment response. The CNN segmentation and prediction utilized multimodality imaging data for a complementary in-depth risk analysis per patient. The following parameters correlated with longer OS: a TMTV < 50 mL; no metastases in the brain, bone, liver, spleen or pleura; ≤4 affected organ regions; no metastases; a Dmlesion > 37 mm or SULpeak < 1.3; a range of the ADCmean < 600 mm2/s. However, none of the parameters correlated significantly with the stratification of the patients into the high- or low-risk groups. For the CNN, the sensitivity, specificity, PPV and accuracy were 92%, 96%, 92% and 95%, respectively. Imaging biomarkers such as the metastatic involvement of specific organs, a high tumor burden, the presence of at least one large lesion or a high range of intermetastatic diffusivity were negative predictors for the OS, but the identification of high-risk patients was not feasible with the handcrafted parameters. In contrast, the proposed CNN supplied risk stratification with high specificity and sensitivity.

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The Role and Potential of 18F-FDG PET/CT in Malignant Melanoma: Prognostication, Monitoring Response to Targeted and Immunotherapy, and Radiomics

Cited by 20 publications

References 78 publications

Skin Cancer Pathobiology at a Glance: A Focus on Imaging Techniques and Their Potential for Improved Diagnosis and Surveillance in Clinical Cohorts

Skin Cancer Pathobiology at a Glance: A Focus on Imaging Techniques and Their Potential for Improved Diagnosis and Surveillance in Clinical Cohorts

Value of 18F-FDG-PET/CT radiomics combined clinical variables in differential diagnosis of malignant and benign vertebral compression fractures

Development of a Hybrid-Imaging-Based Prognostic Index for Metastasized-Melanoma Patients in Whole-Body 18F-FDG PET/CT and PET/MRI Data

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