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CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(02): 176-182
DOI: 10.4103/wjnm.wjnm_37_18
Original Article

Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in restaging and prognosis of recurrent melanoma after curative surgery

Dharmender Malik
0   Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Ashwani Sood
0   Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Bhagwant Rai Mittal
0   Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Rajender Kumar Basher
0   Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Anish Bhattacharya
0   Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Gurpreet Singh
1   Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

Malignant melanoma is a highly aggressive tumor and surgical resection is the primary treatment. However, the chances of recurrence are quite high despite complete resection. The aim of study was to evaluate the 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography–computed tomography (PET/CT) in detection of recurrent melanoma after curative surgery and its prognostic value. Fifty-four melanoma patients (32 women) with prior primary lesion resection were evaluated with 18F-FDG PET/CT for clinically suspicious recurrent disease. The diagnostic accuracy of 18F-FDG PET/CT (visual interpretation as well as semi-quantitative parameter) was determined on the basis of subsequent imaging and clinical follow-up. Melanoma-specific survival and risk of progression (hazard ratio [HR]) were assessed using Kaplan–Meier method and Cox regression analysis.18F-FDG PET/CT detected recurrent diseases in 36 (66%) patients including distant metastases in 13 patients and second synchronous malignancy in 2 patients. Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of 18F-FDG PET/CT were 91.2%, 80.0%, 88.6%, and 84.2%, respectively, with area under the curve of 0.86 (95% confidence interval: 0.74–0.97; P < 0.05). Positive 18F-FDG PET/CT study was associated with a significantly shorter overall survival than negative study (30.8 ± 4.6 vs. 64.5 ± 6.9 months, P < 0.05). Apart from positive 18F-FDG PET/CT scan, maximum standardized uptake value (SUVmax) >2.7 and combination of both were independently associated with an increased risk of disease progression (HR = 7.72, 21.58, and 11.37, respectively; P < 0.05).18F-FDG PET/CT showed enhanced diagnostic performance in patients with suspicious recurrent malignant melanoma leading to appropriate management. FDG positivity along with SUVmax >2.7 provides important prognostic value in predicting the survival outcomes and assessing the risk of disease progression.

Keywords

18F-fluorodeoxyglucose positron emission tomography/computed tomography - malignant melanoma - prognostic factor - prognostic value - survival analysis

Financial support and sponsorship

Nil.




Publication History

Received: 00 00 2019

Accepted: 00 00 2019

Article published online:
22 April 2022

© 2019. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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