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Melanin-targeted [18F]-PFPN PET imaging for prognosticating patients with melanoma

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Abstract

Purpose

Positron emission tomography (PET) using [18F]-PFPN, a melanin-targeted imaging tracer, has excellent diagnostic performance in patients with melanoma. This study aimed to investigate its value in prognostication and determine predictors of progression-free survival (PFS) and overall survival (OS).

Methods

We reviewed melanoma patients who underwent [18F]-PFPN and [18F]-FDG PET from February 2021 to July 2022. Clinical characteristics, follow-up data, and the following [18F]-PFPN PET parameters were recorded: maximum standardized uptake value (SUVmax), whole-body melanotic tumoral volume (WBMTV), and whole-body total lesion melanin (WBTLM). Receiver operating characteristic (ROC), Kaplan–Meier and Cox regression analyses were performed.

Results

Seventy-six patients (47 men and 29 women; mean age, 57.99 ± 10.72 years) were included for analysis. Median follow-up was 12.0 months (range: 1–22 months). Eighteen patients died and 38 experienced progression. Median OS was 17.60 months (95% confidence interval, 15.89–19.31). In the ROC analysis, [18F]-PFPN PET parameters were superior to those of [18F]-FDG PET in prognosticating death and disease progression. PFS and OS were significantly better in patients with lower SUVmax, WBMTV, and WBTLM on [18F]-PFPN PET (log-rank, P < 0.05). In the univariate analyses, distant metastasis, SUVmax, WBMTV, and WBTLM were significantly associated with cumulative incidence of PFS and OS (P < 0.05). In the multivariate analysis, SUVmax was an independent predictor of PFS and OS.

Conclusions

[18F]-PFPN PET has a role in prognostication of melanoma patients. Patients with higher [18F]-PFPN SUVmax have worse prognosis.

Clinical Trial Registration

ClinicalTrials.gov, NCT05645484. Registered 9 December, 2022, https://clinicaltrials.gov/ct2/show/NCT05645484?cond=The+Prognostic+Value+of+18F-PFPN+PET+Imaging+in+Patients+With+Malignant+Melanoma&draw=2&rank=1

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was financially supported by National Natural Science Foundation of China (grants 82030052 and 81901783).

Author information

Author notes

  1. Xiao Zhang and Zhaoguo Lin contribute equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China

    Xiao Zhang, Zhaoguo Lin, Mengting Li, Yongkang Gai, Weiwei Ruan, Fan Hu & Xiaoli Lan

  2. Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China

    Xiao Zhang, Zhaoguo Lin, Mengting Li, Yongkang Gai, Weiwei Ruan, Fan Hu & Xiaoli Lan

  3. Key Laboratory of Biological Targeted Therapy, the Ministry of Education, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China

    Xiao Zhang & Xiaoli Lan

  4. Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China

    Huaiyuan Zheng

  5. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Ave, Wuhan, 430022, Hubei Province, China

    Li Fan & Jing Chen

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  1. Xiao Zhang
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Contributions

Xiaoli Lan: study design. Xiao Zhang and Zhaoguo Lin: statistical analysis and manuscript writing. Mengting Li and Yongkang Gai: radiopharmaceutical synthesis and quality control testing. Jing Chen, Huaiyuan Zheng and Li Fan: patient recruitment. Xiaoli Lan, Xiao Zhang, Weiwei Ruan and Fan Hu: image acquisition and interpretation. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jing Chen or Xiaoli Lan.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (approval number: 0624/2022).

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 4 and 5.

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The authors declare no competing interests.

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Zhang, X., Lin, Z., Li, M. et al. Melanin-targeted [18F]-PFPN PET imaging for prognosticating patients with melanoma. Eur J Nucl Med Mol Imaging 50, 3062–3071 (2023). https://doi.org/10.1007/s00259-023-06258-5

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