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Prognostic Value of 2-[18F]Fdg Pet-Ct in Metastatic Melanoma Patients Receiving Immunotherapy Publisher Pubmed



Schweighoferzwink G1 ; Manafifarid R2 ; Kolblinger P3 ; Hehenwarter L1 ; Harsini S2, 4 ; Pirich C1 ; Beheshti M1
Authors
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Authors Affiliations
  1. 1. Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, 5020, Austria
  2. 2. Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical sciences, Tehran, 1411713135, Iran
  3. 3. Department of Dermatology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, 5020, Austria
  4. 4. Association of Nuclear Medicine and Molecular Imaging (ANMMI), Universal Scientific Education and Research Network (USERN), Tehran, 1419733151, Iran

Source: European Journal of Radiology Published:2022


Abstract

Purpose: The 2-fluorodeoxyglucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) is used for the evaluation of response to immunotherapy in malignant melanoma. Here, we evaluated the prognostic value of various metabolic parameters in baseline and different time points after therapy. Methods: In this retrospective study, 51 metastatic melanoma patients, who had received immunotherapy, were included. Patients with baseline and two follow-up 2-[18F]FDG PET/CT studies (3 and 6 months after therapy) were selected. Multiple metabolic parameters and tumor-to-background ratios (TBRs) were extracted and correlated with OS. Results: The 3- and 5-year OS rates were 49% and 43.1%, respectively. On baseline 2-[18F]FDG PET/CT, only standardized uptake value corrected for lean body mass (SULmax and SULpeak), as well as most of the TBRs were predictive for 3- and 5-year OS rates. Metabolic tumor volume (MTV), total lesion glycolysis (TLG), and most of the TBRs were predictive on both follow-up studies. Also, the changes in values of MTV, TLG and most of the TBRs from the baseline to the 3-month and 6- month follow-up studies were prognostic. On multivariate analysis, all of the most predictive parameters for OS were derived from the 3-month follow-up study. The ratio of TBRmean to the mediastinum was the best factor (cutoff value of 2.15, sensitivity of 88.5% and specificity of 68.0% for 3-year survival). Conclusion: Metabolic parameters derived from 2-[18F]FDG PET/CT are valuable tools for the prediction of 3- and 5-year OS rates in metastatic melanoma patients undergoing immunotherapy. The 3-month follow-up 2-[18F]FDG PET/CT is of particular importance in this regard. © 2021 The Authors
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