What’s New in PET/CT

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

PET/CT Updates, Research & Education
May 2021

Purpose

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 follow-up 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.

Source: El-Shourbagy, K.H., Mashaly, E.M., Khodair, S.A. et al. PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma. Egypt J Radiol Nucl Med 51, 167 (2020). https://doi.org/10.1186/s43055-020-00276-1 <https://ejrnm.springeropen.com/articles/10.1186/s43055-020-00276-1>
Retrieved 20 April 2021.

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Skin Cancer Awareness Month

  • The American Cancer Society predicts over 100,000 new melanomas will be diagnosed in 2021.

  • The rates of melanoma have been rising rapidly over the past few decades, but this has varied by age.

  • The risk of melanoma increases as people age, with the average age of diagnosis being 65. However, it is one of the most common cancers in young adults.

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