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Prognostic Value of Baseline 18F-FDG PET/CT to Predict Brain Metastasis Development in Melanoma Patients

#2024
#Cancers

PMU Authors
M. Hoellwerth, G. Schweighofer-Zwink, W. Hitzl, G. Rendl, P. Koelblinger, C. Pirich, M. Beheshti

All Authors
F. Kalantari, SA Mirshahvalad, M. Hoellwerth, G. Schweighofer-Zwink, U. Huber-Schönauer, W. Hitzl, G. Rendl, P. Koelblinger, C. Pirich, M. Beheshti

Journal association
Cancers

Abstract

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.

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Keywords

CANCER, PROGRESSION, AGE, SURVIVAL, GUIDELINES, TUMOR, melanoma, FDG PET/CT, brain metastasis, predictive value, CUTANEOUS MELANOMA

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Paracelsus Medical Private University (PMU) Research & Innovation Publications
Prognostic Value of Baseline <sup>18</sup>F-FDG...