TY - JOUR
T1 - Prognostic Value of Baseline 18F-FDG PET/CT to Predict Brain Metastasis Development in Melanoma Patients
AU - Kalantari, F
AU - Mirshahvalad, SA
AU - Hoellwerth, M
AU - Schweighofer-Zwink, G
AU - Huber-Schönauer, U
AU - Hitzl, W
AU - Rendl, G
AU - Koelblinger, P
AU - Pirich, C
AU - Beheshti, M
N1 - Kalantari, Mirshahvalad, Schweighofer-Zwink, Huber-Schönauer, Rendl, Pirich, Beheshti: Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria; Hoellwerth, Koelblinger: Department of Dermatology, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria; Hitzl: Biostatistics and Publication of Clinical Trial Studies, Research and Innovation Management (RIM), Paracelsus Medical University, 5020 Salzburg, Austria; Department of Ophthalmology and Optometry, Paracelsus Medical University, 5020 Salzburg, Austria; Research Program Experimental Ophthalmology & Glaucoma Research, Paracelsus Medical University, 5020 Salzburg, Austria
PY - 2024/1
Y1 - 2024/1
N2 - To investigate the value of F-18-FDG-PET/CT in predicting the occurrence of brain metastases in melanoma patients, in this retrospective study 201 consecutive patients with pathology-proven melanoma, between 2008 and 2021, were reviewed. Those who underwent (18)8F-FDG-PET/CT for initial staging were considered eligible. Baseline assessment included histopathology, 18F-FDG-PET/CT, and brain MRI. Also, all patients had serial follow-ups for diagnosing brain metastasis development. Baseline F-18-FDG-PET/CT parameters were analysed using competing risk regression models to analyze their correlation with the occurrence of brain metastases. Overall, 159 patients entered the study. The median follow-up was six years. Among clinical variables, the initial M-stage and TNM-stage were significantly correlated with brain metastasis. Regarding F-18-FDG-PET/CT parameters, regional metastatic lymph node uptake values, as well as prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), were significantly correlated with the outcome. Cumulative incidences were 10% (6.3-16%), 31% (24.4-38.9%), and 35.2% (28.5-43.5%) after 1, 5, and 10 years. There were significant correlations between pSULmax (p-value < 0.001) and pSULpeak (p-value < 0.001) and the occurrence of brain metastases. The higher these values, the sooner the patient developed brain metastases. Thus, baseline F-18-FDG-PET/CT may have the potential to predict brain metastasis in melanoma patients. Those with high total metabolic activity should undergo follow-up/complementary evaluations, such as brain MRI.
AB - To investigate the value of F-18-FDG-PET/CT in predicting the occurrence of brain metastases in melanoma patients, in this retrospective study 201 consecutive patients with pathology-proven melanoma, between 2008 and 2021, were reviewed. Those who underwent (18)8F-FDG-PET/CT for initial staging were considered eligible. Baseline assessment included histopathology, 18F-FDG-PET/CT, and brain MRI. Also, all patients had serial follow-ups for diagnosing brain metastasis development. Baseline F-18-FDG-PET/CT parameters were analysed using competing risk regression models to analyze their correlation with the occurrence of brain metastases. Overall, 159 patients entered the study. The median follow-up was six years. Among clinical variables, the initial M-stage and TNM-stage were significantly correlated with brain metastasis. Regarding F-18-FDG-PET/CT parameters, regional metastatic lymph node uptake values, as well as prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), were significantly correlated with the outcome. Cumulative incidences were 10% (6.3-16%), 31% (24.4-38.9%), and 35.2% (28.5-43.5%) after 1, 5, and 10 years. There were significant correlations between pSULmax (p-value < 0.001) and pSULpeak (p-value < 0.001) and the occurrence of brain metastases. The higher these values, the sooner the patient developed brain metastases. Thus, baseline F-18-FDG-PET/CT may have the potential to predict brain metastasis in melanoma patients. Those with high total metabolic activity should undergo follow-up/complementary evaluations, such as brain MRI.
KW - melanoma
KW - FDG PET/CT
KW - survival
KW - brain metastasis
KW - predictive value
KW - CUTANEOUS MELANOMA
KW - TUMOR
KW - PROGRESSION
KW - GUIDELINES
KW - SURVIVAL
KW - CANCER
KW - AGE
U2 - 10.3390/cancers16010127
DO - 10.3390/cancers16010127
M3 - Original Article
C2 - 38201554
SN - 2072-6694
VL - 16
JO - Cancers
JF - Cancers
IS - 1
M1 - 127
ER -