open access
Diagnostic and clinical value of [18F]FDG PET/CT in the follow-up regimen in IIA–IIID stage cutaneous malignant melanoma after first regional recurrence
, 2, 1, 1, 1, 1
Affiliations- Department of Imaging Diagnostics, Interventional Radiology and Radiotherapy, Medical University “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria
- Prof. Asen Zlatarov University, Burgas, Bulgaria
open access
Abstract
Background: Malignant melanoma stands out as a disease with highly aggressive behavior and frequent recurrences. It is crucial to find a non-invasive method for early recurrence detection which allows early and radical treatment. Our aim was to assess the diagnostic and clinical value of [18F]FDG PET/CT in the follow-up regimen of patients after radically treated first regional recurrence and for early detection of operable disease progression.
Material and methods: We performed [18F]FDG PET/CT in 96 consecutive patients who had a histologically proven regional recurrent disease that was radically treated. In 46 patients [18F]FDG PET/CT was used in the follow-up regimen and in the other 50 it was used for clarification of suspicious lesions seen in conventional studies. We explored the diagnostic performance of [18F]FDG PET/CT. We also compared the results with conventional studies and explored the clinical impact of [18F]FDG PET/CT by its ability to find localized disease progression in those groups.
Results: [18F]FDG PET/CT had better sensitivity, specificity, PPV and NPV, and accuracy in patients with symptoms. Good results in the second group had a high price for the patients, as there was a prevalence of distant metastatic disease in the second group — 64.0% vs. 28.3% in the surveillance group (p = 0.001). [18F]FDG PET/CT revealed more of the distant and in-transit lesions and assisted in lymph node detection by guiding the ultrasonography. Owing to the [18F]FDG PET/CT surveillance, 64.5% of all operable lesions were found in the surveillance group vs. only 35.5% in the second group, where the distant metastatic disease was prevalent.
Conclusions: [18F]FDG PET/CT used as a follow-up tool in the surveillance regimen of patients after the first recurrence showed excellent performance in timely and accurate recognition of operable lesions. It had significantly better performance than conventional studies in the follow-up regimen of the patients in this high risk of progression group.
Abstract
Background: Malignant melanoma stands out as a disease with highly aggressive behavior and frequent recurrences. It is crucial to find a non-invasive method for early recurrence detection which allows early and radical treatment. Our aim was to assess the diagnostic and clinical value of [18F]FDG PET/CT in the follow-up regimen of patients after radically treated first regional recurrence and for early detection of operable disease progression.
Material and methods: We performed [18F]FDG PET/CT in 96 consecutive patients who had a histologically proven regional recurrent disease that was radically treated. In 46 patients [18F]FDG PET/CT was used in the follow-up regimen and in the other 50 it was used for clarification of suspicious lesions seen in conventional studies. We explored the diagnostic performance of [18F]FDG PET/CT. We also compared the results with conventional studies and explored the clinical impact of [18F]FDG PET/CT by its ability to find localized disease progression in those groups.
Results: [18F]FDG PET/CT had better sensitivity, specificity, PPV and NPV, and accuracy in patients with symptoms. Good results in the second group had a high price for the patients, as there was a prevalence of distant metastatic disease in the second group — 64.0% vs. 28.3% in the surveillance group (p = 0.001). [18F]FDG PET/CT revealed more of the distant and in-transit lesions and assisted in lymph node detection by guiding the ultrasonography. Owing to the [18F]FDG PET/CT surveillance, 64.5% of all operable lesions were found in the surveillance group vs. only 35.5% in the second group, where the distant metastatic disease was prevalent.
Conclusions: [18F]FDG PET/CT used as a follow-up tool in the surveillance regimen of patients after the first recurrence showed excellent performance in timely and accurate recognition of operable lesions. It had significantly better performance than conventional studies in the follow-up regimen of the patients in this high risk of progression group.
Keywords
cutaneous melanoma, [18F]FDG PET/CT, follow up
About this articleTitle
Diagnostic and clinical value of [18F]FDG PET/CT in the follow-up regimen in IIA–IIID stage cutaneous malignant melanoma after first regional recurrence
Journal
Issue
Vol 26 (2023): Continuous Publishing
Article type
Research paper
Pages
20-28
Published online
2022-11-22
Page views
2842
Article views/downloads
343
DOI
Pubmed
Bibliographic record
Nucl. Med. Rev 2023;26:20-28.
Keywords
cutaneous melanoma
[18F]FDG PET/CT
follow up
Authors
Zhivka Dancheva
Assia Konsoulova
Marina Dyankova
Tanya Stoeva
Sofiya Chausheva
Aneliya Klisarova
References (23)- Soong SJ, Harrison RA, McCarthy WH, et al. Factors affecting survival following local, regional, or distant recurrence from localized melanoma. J Surg Oncol. 1998; 67(4): 228–233, doi: 10.1002/(sici)1096-9098(199804)67:4<228::aid-jso4>3.0.co;2-a.
- Reintgen DS, Cox C, Slingluff CL, et al. Recurrent malignant melanoma: the identification of prognostic factors to predict survival. Ann Plast Surg. 1992; 28(1): 45–49.
- Cruse CW, Wells KE, Schroer KR, et al. Etiology and prognosis of local recurrence in malignant melanoma of the skin. Ann Plast Surg. 1992; 28(1): 26–28.
- Chavdarova L, Gavrilova I, Piperkova E. 18 F-FDG-PET/CT in the staging, follow-up and treatment tailoring of Malignant Melanoma – first “full digital” experience in a single institution. 34-th Congress of EANM – Virtual – 20-23.10.2021. Clinical Oncology Track - TROP Session: Gynaecological and Melanoma. Eur J Nuc Med Mol Imaging. 2021; 48(Suppl 1 OP-1078): 378–379.
- Swetter SM, Thompson JA, Albertini MR, et al. NCCN Guidelines® Insights: Melanoma: Cutaneous, Version 2.2021. J Natl Compr Canc Netw. 2021; 19(4): 364–376.
- Speijers M, Francken A, Hoekstra-Weebers J, et al. Optimal follow-up for melanoma. Expert Rev Dermatol. 2014; 5(4): 461–478.
- Dong X, Tyler D, Johnson J, et al. Analysis of prognosis and disease progression after local recurrence of melanoma. Cancer. 2000; 88(5): 1063–1071, doi: 10.1002/(sici)1097-0142(20000301)88:5<1063::aid-cncr17>3.0.co;2-e .
- Garbe C, Paul A, Kohler-Späth H, et al. Prospective evaluation of a follow-up schedule in cutaneous melanoma patients: recommendations for an effective follow-up strategy. J Clin Oncol. 2003; 21(3): 520–529.
- Generalitat Valenciana. Health Council. [Guideline for prevention and treatment of melanoma].
- Guillot B, Dalac S, Denis MG, et al. French updated recommendations in Stage I to III melanoma treatment and management. J Eur Acad Dermatol Venereol. 2017; 31(4): 594–602.
- Hölmich LR, Klausen S, Spaun E, et al. The Danish Melanoma Database. Clin Epidemiol. 2016; 8: 543–548.
- Vensby PH, Schmidt G, Kjær A, et al. The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis. Am J Nucl Med Mol Imaging. 2017; 7(6): 255–262.
- Michielin O, van Akkooi A, Lorigan P, et al. ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee. Ann Oncol. 2020; 31(11): 1449–1461.
- Weiss M, Loprinzi CL, Creagan ET, et al. Utility of follow-up tests for detecting recurrent disease in patients with malignant melanomas. JAMA. 1995; 274(21): 1703–1705.
- Bassères N, Grob JJ, Richard MA, et al. Cost-effectiveness of surveillance of stage I melanoma. A retrospective appraisal based on a 10-year experience in a dermatology department in France. Dermatology. 1995; 191(3): 199–203.
- Bastien M, Tessier MH, Legoux B, et al. Usefulness of paraclinical follow-up in stage I melanoma. Arch Dermatol. 1997; 133(11): 1462–1463.
- Kelly J, Blois M, Sagebiel R. Frequency and duration of patient follow-up after treatment of a primary malignant melanoma. J Am Acad Dermatol. 1985; 13(5): 756–760.
- Martini L, Brandani P, Chiarugi C, et al. First recurrence analysis of 840 cutaneous melanomas: a proposal for a follow-up schedule. Tumori. 1994; 80(3): 188–197.
- Fusi S, Ariyan S, Sternlicht A. Data on first recurrence after treatment for malignant melanoma in a large patient population. Plast Reconstr Surg. 1993; 91(1): 94–98.
- Xing Y, Bronstein Y, Ross MI, et al. Contemporary diagnostic imaging modalities for the staging and surveillance of melanoma patients: a meta-analysis. J Natl Cancer Inst. 2011; 103(2): 129–142.
- Brady MS, Akhurst T, Spanknebel K, et al. Utility of preoperative [(18)]f fluorodeoxyglucose-positron emission tomography scanning in high-risk melanoma patients. Ann Surg Oncol. 2006; 13(4): 525–532.
- Schüle SC, Eigentler TK, Garbe C, et al. Influence of (18)F-FDG PET/CT on therapy management in patients with stage III/IV malignant melanoma. Eur J Nucl Med Mol Imaging. 2016; 43(3): 482–488.
- Danielsen M, Højgaard L, Kjær A, et al. Positron emission tomography in the follow-up of cutaneous malignant melanoma patients: a systematic review. Am J Nucl Med Mol Imaging. 2013; 4(1): 17–28.
