18F-FDG-PET/CT helps in prediction of brain metastasis in melanoma patients

Malignant melanoma is known for its aggressive nature and disproportionately high mortality rate among skin-related malignancies and is the third most common cancer to metastasize to the brain. A recent retrospective study published in the Journal of Cancers unveiled the potential breakthrough in prediction of brain metastases in melanoma patients.

18F-FDG PET/CT is a powerful imaging modality for detecting melanoma metastases, this study evaluated its prognostic value in the context of brain metastases. The limitation of 18F-FDG PET/CT, an unfavorable tumor-to-background uptake ratio in the brain, prompted researchers to explore its potential as a prognostic tool.

This retrospective analysis included a total of 201 melanoma patients with pathology-proven cases between 2008 and 2021. The baseline assessments included histopathology, 18F-FDG PET/CT, and brain MRI. A median follow-up of six years was conducted that revealed intriguing associations.

Among the clinical variables, the initial M-stage and TNM-stage were significantly associated to the occurrence of brain metastasis.18F-FDG PET/CT parameters, specially regional metastatic lymph node uptake values, prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), demonstrated significant links with the outcome.

The cumulative incidences observed following 1, 5, and 10 years were 10%, 31%, and 35.2%, respectively. The notable significance were the correlations between pSULmax and pSUVmean and the occurrence of brain metastases, where higher values corresponded to a swifter development of brain metastases.

This outcomes not only highlight the potential of baseline 18F-FDG PET/CT in predicting brain metastasis but also emphasize the importance of follow-up and complementary evaluations, like the MRI brain for melanoma patients with high total metabolic activity.

This study deepens the understanding of melanoma progression and also improves possibilities of targeted and timely interventions by potentially transforming the melanoma management.

Source:

Kalantari, F., Mirshahvalad, S. A., Hoellwerth, M., Schweighofer-Zwink, G., Huber-Schönauer, U., Hitzl, W., Rendl, G., Koelblinger, P., Pirich, C., & Beheshti, M. (2023). Prognostic Value of Baseline 18F-FDG PET/CT to Predict Brain Metastasis Development in Melanoma Patients. In Cancers (Vol. 16, Issue 1, p. 127). MDPI AG. https://doi.org/10.3390/cancers16010127