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Khalid M, Sutterfield B, Minley K, Ottwell R, Abercrombie M, Heath C, Torgerson T, Hartwell M, Vassar M. The Reporting and Methodological Quality of Systematic Reviews Underpinning Clinical Practice Guidelines Focused on the Management of Cutaneous Melanoma: Cross-Sectional Analysis. JMIR DERMATOLOGY 2023; 6:e43821. [PMID: 38060306 PMCID: PMC10739238 DOI: 10.2196/43821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/28/2023] [Accepted: 09/15/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Clinical practice guidelines (CPGs) inform evidence-based decision-making in the clinical setting; however, systematic reviews (SRs) that inform these CPGs may vary in terms of reporting and methodological quality, which affects confidence in summary effect estimates. OBJECTIVE Our objective was to appraise the methodological and reporting quality of the SRs used in CPGs for cutaneous melanoma and evaluate differences in these outcomes between Cochrane and non-Cochrane reviews. METHODS We conducted a cross-sectional analysis by searching PubMed for cutaneous melanoma guidelines published between January 1, 2015, and May 21, 2021. Next, we extracted SRs composing these guidelines and appraised their reporting and methodological rigor using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklists. Lastly, we compared these outcomes between Cochrane and non-Cochrane SRs. All screening and data extraction occurred in a masked, duplicate fashion. RESULTS Of the SRs appraised, the mean completion rate was 66.5% (SD 12.29%) for the PRISMA checklist and 44.5% (SD 21.05%) for AMSTAR. The majority of SRs (19/50, 53%) were of critically low methodological quality, with no SRs being appraised as high quality. There was a statistically significant association (P<.001) between AMSTAR and PRISMA checklists. Cochrane SRs had higher PRISMA mean completion rates and higher methodological quality than non-Cochrane SRs. CONCLUSIONS SRs supporting CPGs focused on the management of cutaneous melanoma vary in reporting and methodological quality, with the majority of SRs being of low quality. Increasing adherence to PRISMA and AMSTAR checklists will likely increase the quality of SRs, thereby increasing the level of evidence supporting cutaneous melanoma CPGs.
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Affiliation(s)
- Mahnoor Khalid
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Bethany Sutterfield
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States
| | - Kirstien Minley
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States
| | - Ryan Ottwell
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States
| | - McKenna Abercrombie
- Dermatology Residency, Trinity Health Ann Arbor Hospital, Ypsilanti, MI, United States
| | - Christopher Heath
- Dermatology Residency, Trinity Health Ann Arbor Hospital, Ypsilanti, MI, United States
| | - Trevor Torgerson
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States
| | - Micah Hartwell
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States
| | - Matt Vassar
- Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, United States
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2
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Pyo A, Yun M, Song B, Kwon SY, Min JJ, Kim DY. Synthesis and evaluation of 18F-labeled procainamide as a PET imaging agent for malignant melanoma. Bioorg Med Chem Lett 2023; 96:129528. [PMID: 37852422 DOI: 10.1016/j.bmcl.2023.129528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/14/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
Malignant melanoma has an aggressive nature and a high metastatic propensity resulting in the highest mortality rate of any skin cancer. In this study, we synthesized 18F-labeled procainamide (PCA) for detection of melanoma using positron emission tomography (PET), and evaluated its biological characteristics. The non-decay-corrected radiochemical yield of 18F-PCA was 10-15% and its in vitro stability was over 98% for 2 h. At 1 h, cellular uptake of 18F-PCA was 3.8-fold higher in a group with the presence of l-tyrosine than in a non-l-tyrosine-treated group. Furthermore, 18F-PCA permitted visualization of B16F10 (mouse melanoma) xenografts on microPET after intravenous injection, and was retained in the tumor for 60 min, with a high tumor-to-liver uptake ratio. 18F-PCA showed specific melanoma uptake in primary lesions with a high melanin targeting ability in small animal models. 18F-PCA may have potential as a PET imaging agent for direct melanoma detection.
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Affiliation(s)
- Ayoung Pyo
- College of Pharmacy and Research Institute of Pharmaceutical Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Misun Yun
- Hygenic Safety-Material Research Group, Technology Innovation Research Division, World Institute of Kimchi, Gwangju, Republic of Korea
| | - Boreum Song
- College of Pharmacy and Research Institute of Pharmaceutical Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Seong-Young Kwon
- Innovation Center for Molecular Probe Development, Department of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of Korea
| | - Jung-Joon Min
- Innovation Center for Molecular Probe Development, Department of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of Korea; CNCure Biotech, Hwasun, Republic of Korea
| | - Dong-Yeon Kim
- College of Pharmacy and Research Institute of Pharmaceutical Science, Gyeongsang National University, Jinju, Republic of Korea; CNCure Biotech, Hwasun, Republic of Korea.
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3
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Hirsiger S, Olariu R. Schwannomas mistaken for metastases of melanoma in PET-CT: A diagnostic challenge with consequences. Clin Case Rep 2022; 10:e6753. [PMID: 36583202 PMCID: PMC9794678 DOI: 10.1002/ccr3.6753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/11/2022] [Accepted: 12/01/2022] [Indexed: 12/29/2022] Open
Abstract
The incidence of skin cancer and especially cutaneous malignant melanoma is rising, as are indications for staging examinations to detect metastasis. Schwannomas are common benign nerve tumors, which can be mistaken for metastasis even in highly specialized imaging. Risk of nerve lesion is high in inadvertent biopsy.
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Affiliation(s)
- Stefanie Hirsiger
- Department of Plastic and Hand Surgery, Inselspital University Hospital BernUniversity of BernBernSwitzerland
| | - Radu Olariu
- Department of Plastic and Hand Surgery, Inselspital University Hospital BernUniversity of BernBernSwitzerland
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4
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Bellavia MC, Nyiranshuti L, Latoche JD, Ho KV, Fecek RJ, Taylor JL, Day KE, Nigam S, Pun M, Gallazzi F, Edinger RS, Storkus WJ, Patel RB, Anderson CJ. PET Imaging of VLA-4 in a New BRAF V600E Mouse Model of Melanoma. Mol Imaging Biol 2022; 24:425-433. [PMID: 34694528 PMCID: PMC9183947 DOI: 10.1007/s11307-021-01666-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE Despite unprecedented responses to immune checkpoint inhibitors and targeted therapy in melanoma, a major subset of patients progresses and have few effective salvage options. We have previously demonstrated robust, selective uptake of the peptidomimetic LLP2A labeled with Cu-64 ([64Cu]-LLP2A) for positron emission tomography (PET) imaging in subcutaneous and metastatic models of B16F10 murine melanoma. LLP2A binds with high affinity to very late antigen-4 (VLA-4, integrin α4β1), a transmembrane protein overexpressed in melanoma and other cancers that facilitates tumor growth and metastasis. Yet B16F10 fails to faithfully reflect human melanoma biology, as it lacks certain oncogenic driver mutations, including BRAF mutations found in ≥ 50 % of clinical specimens. Here, we evaluated the PET tracer [64Cu]-CB-TE1A1P-PEG4-LLP2A ([64Cu]-LLP2A) in novel, translational BRAFV600E mutant melanoma models differing in VLA-4 expression-BPR (VLA-4-) and BPRα (VLA-4+). PROCEDURES BPR cells were transduced with α4 (CD49d) to overexpress intact cell surface VLA-4 (BPRα). The binding affinity of [64Cu]-LLP2A to BPR and BPRα cells was determined by saturation binding assays. [64Cu]-LLP2A internalization into B16F10, BPR, and BPRα cells was quantified via a plate-based assay. Tracer biodistribution and PET/CT imaging were evaluated in mice bearing subcutaneous BPR and BPRα tumors. RESULTS [64Cu]-LLP2A demonstrated high binding affinity to BPRα (Kd = 1.4 nM) but indeterminate binding to BPR cells. VLA-4+ BPRα and B16F10 displayed comparable time-dependent [64Cu]-LLP2A internalization, whereas BPR internalization was undetectable. PET/CT showed increased tracer uptake in BPRα tumors vs. BPR tumors in vivo, which was validated by significantly greater (p < 0.0001) BPRα tumor uptake in biodistribution analyses. CONCLUSIONS [64Cu]-LLP2A discriminates BPRα (VLA-4+) vs. BPR (VLA-4-) melanomas in vivo, supporting translation of these BRAF-mutated melanoma models via prospective imaging and theranostic studies. These results extend the utility of LLP2A to selectively target clinically relevant and therapy-resistant tumor variants toward its use for therapeutic patient care.
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Affiliation(s)
- Michael C Bellavia
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Lea Nyiranshuti
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, 90095, USA
- RayzeBio Inc., San Diego, CA, 92121, USA
| | - Joseph D Latoche
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Khanh-Van Ho
- Department of Chemistry, University of Missouri, Columbia, MO, 65211, USA
| | - Ronald J Fecek
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Microbiology and Immunology, Lake Erie College of Osteopathic Medicine at Seton Hill, Greensburg, PA, 15601, USA
| | - Jennifer L Taylor
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Kathryn E Day
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Shubhanchi Nigam
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Eurofins Scientific, Philadelphia, PA, 19355, USA
| | - Michael Pun
- Department of Chemistry, University of Missouri, Columbia, MO, 65211, USA
| | - Fabio Gallazzi
- Department of Chemistry, University of Missouri, Columbia, MO, 65211, USA
| | - Robert S Edinger
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Radiation Oncology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Walter J Storkus
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Ravi B Patel
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
- Department of Radiation Oncology, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
| | - Carolyn J Anderson
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
- Department of Chemistry, University of Missouri, Columbia, MO, 65211, USA.
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
- Department of Radiology, University of Missouri, Columbia, MO, 65211, USA.
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Kaleem A, Patel N, Chandra SR, Vijayaraghavan R. Imaging and Laboratory Workup for Melanoma. Oral Maxillofac Surg Clin North Am 2022; 34:235-250. [DOI: 10.1016/j.coms.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Alipour R, Iravani A, Hicks RJ. PET Imaging of Melanoma. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Newcomer K, Robbins KJ, Perone J, Hinojosa FL, Chen D, Jones S, Kaufman CK, Weiser R, Fields RC, Tyler DS. Malignant melanoma: evolving practice management in an era of increasingly effective systemic therapies. Curr Probl Surg 2022; 59:101030. [PMID: 35033317 PMCID: PMC9798450 DOI: 10.1016/j.cpsurg.2021.101030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/12/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Ken Newcomer
- Department of Surgery, Barnes-Jewish Hospital, Washington University, St. Louis, MO
| | | | - Jennifer Perone
- Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | | | - David Chen
- e. Department of Medicine, Washington University, St. Louis, MO
| | - Susan Jones
- f. Department of Pediatrics, Washington University, St. Louis, MO
| | | | - Roi Weiser
- University of Texas Medical Branch, Galveston, TX
| | - Ryan C Fields
- Department of Surgery, Washington University, St. Louis, MO
| | - Douglas S Tyler
- Department of Surgery, University of Texas Medical Branch, Galveston, TX.
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8
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Wright CL, Miller ED, Contreras C, Knopp MV. Precision Nuclear Medicine: The Evolving Role of PET in Melanoma. Radiol Clin North Am 2021; 59:755-772. [PMID: 34392917 DOI: 10.1016/j.rcl.2021.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The clinical management of melanoma patients has been rapidly evolving with the introduction of new targeted immuno-oncology (IO) therapeutics. The current diagnostic paradigms for melanoma patients begins with the histopathologic confirmation of melanoma, initial staging of disease burden with imaging and surgical approaches, treatment monitoring during systemic cytotoxic chemotherapy or IO therapeutics, restaging after completion of adjuvant systemic, surgical, and/or external radiation therapy, and the detection of recurrent malignancy/metastatic disease following therapy. New and evolving imaging approaches with positron-emission tomography (PET) imaging technologies, imaging methodologies, image reconstruction, and image analytics will likely continue to improve tumor detection, tumor characterization, and diagnostic confidence, enabling novel precision nuclear medicine practices for managing melanoma patients. This review will examine current concepts and challenges with existing PET imaging diagnostics for melanoma patients and introduce exciting new opportunities for PET in the current era of IO therapeutics.
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Affiliation(s)
- Chadwick L Wright
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 460, Columbus, OH 43210, USA.
| | - Eric D Miller
- Department of Radiation Oncology, James Cancer Center, The Ohio State University Wexner Medical Center, 460 W. 10th Avenue, 2nd Floor, Columbus, OH 43210, USA
| | - Carlo Contreras
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, 2050 Kenny Road, Tower 4th Floor, Columbus, OH 43221, USA
| | - Michael V Knopp
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 460, Columbus, OH 43210, USA
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9
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Van de Wiele C, Juanito G, Vander BK, Lawal I, De Spiegeleer B, Sathekge M, Maes A. Practical Considerations When Interpreting FDG PET/CT Imaging for Staging and Treatment Response Assessment in Melanoma Patients. Semin Nucl Med 2021; 51:544-553. [PMID: 34246450 DOI: 10.1053/j.semnuclmed.2021.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While FDG PET/CT bears a high sensitivity and specificity for the staging of stage III and IV melanoma as well as for the purpose of melanoma recurrence detection, overall results tend to vary from one part of the body to another as well as for melanoma from cutaneous or choroidal origin. In this paper, organ or site-related differences in sensitivity and specificity in melanoma patients, both from cutaneous and choroidal origin, as well as their impact on clinical decision making are discussed. Furthermore, with the advent of immunotherapy for the treatment of malignant melanoma, post-treatment related potential false positive findings have emerged, the knowledge of which is essential for accurate treatment response assessment. These post-treatment related potential false positive findings are summarized in this paper so as to help the nuclear medicine physician in avoiding erroneous interpretation of acquired FDG PET/CT images in melanoma patients receiving immuntherapy.
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Affiliation(s)
- Christophe Van de Wiele
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Diagnostic Sciences, University Ghent, Ghent, Belgium.
| | | | - Borght K Vander
- DRUQUAR, Laboratory of Drug Quality and Registration, Department of Pharmaceutical Sciences, University Ghent, Ghent, Belgium
| | - Ismaheel Lawal
- Department of Nuclear Medicine, University of Pretoria, Pretoria, South-Africa
| | - Bart De Spiegeleer
- DRUQUAR, Laboratory of Drug Quality and Registration, Department of Pharmaceutical Sciences, University Ghent, Ghent, Belgium
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria, South-Africa
| | - Alex Maes
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Morphological Sciences, University Leuven, Leuven, Belgium
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Matiszick A, Völker C, Garbe C, Gutzmer R, Forschner A, Wagner G, Franzius C, Czech N, Schüssler F, Meier F, Sachse MM. PET/CT bei Patienten mit Melanom: eine Zweiklassenversorgung? Stand der Versorgung mit PET/CT in der primären Ausbreitungsdiagnostik des Melanoms. J Dtsch Dermatol Ges 2021; 19:852-863. [PMID: 34139088 DOI: 10.1111/ddg.14386_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Antonia Matiszick
- Fakultät VI - Medizin und Gesundheitswissenschaften, European Medical School, Universität Oldenburg.,Hautkrebszentrum, Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven
| | - Charlyn Völker
- Fakultät VI - Medizin und Gesundheitswissenschaften, European Medical School, Universität Oldenburg.,Hautkrebszentrum, Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven
| | - Claus Garbe
- Sektion Dermatologische Onkologie, Universitäts-Hautklinik, Eberhard Karls Universität, Tübingen
| | - Ralf Gutzmer
- Haut-Tumor-Zentrum, Medizinische Hochschule Hannover
| | - Andrea Forschner
- Sektion Dermatologische Onkologie, Universitäts-Hautklinik, Eberhard Karls Universität, Tübingen
| | - Gunnar Wagner
- Hautkrebszentrum, Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven
| | | | | | - Frank Schüssler
- Institut für angewandte Photogrammmetrie und Geoinformatik, Jade Hochschule, Oldenburg
| | - Friedegund Meier
- Hauttumorzentrum, Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - Michael Max Sachse
- Hautkrebszentrum, Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven
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11
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Matiszick A, Völker C, Garbe C, Gutzmer R, Forschner A, Wagner G, Franzius C, Czech N, Schüssler F, Meier F, Sachse MM. PET/CT in malignant melanoma: a two-tiered healthcare system? Updated healthcare situation regarding initial staging of malignant melanoma with PET/CT. J Dtsch Dermatol Ges 2021; 19:852-862. [PMID: 33890389 DOI: 10.1111/ddg.14386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with stage IIC malignant melanoma are recommended to undergo cross-sectional imaging for initial staging. PET/CT is superior to other methods regarding its diagnostic accuracy of the tumor spread in stage III. So far there is no meaningful data on the nationwide availability, usage and cost recovery of this imaging technique. PATIENTS AND METHODS Questionnaires on the healthcare situation in 2018 were sent to all German dermatology clinics and PET/CT centers in March and April 2019. RESULTS 61.2 % of the dermatology clinics (71/115) and 48.2 % of the PET/CT centers (77/160) took part in the survey. A total of 22,645 patients with malignant melanoma were seen in these clinics in 2018. 16.8 % of the patients with stage IIC melanoma received a PET/CT for primary staging. The costs of this examination were covered for all statutory and privately insured patients in 40 % and 68 % of dermatology clinics (20/50 and 34/50), respectively. 68.0 % (34/50) of all dermatology clinics reported relevant changes of treatment according to PET/CT findings. Long examination periods by the health insurance companies and the time required to submit the application were the most common reasons for dermatology clinics to reject a request for PET/CT. Relevant incidental findings were reported in 90.2 % (47/51) of all PET/CT centers. CONCLUSIONS There are clear differences in the nationwide availability and cost coverage of PET/CT in primary staging for stage IIC melanoma. For these reasons, a two-tiered healthcare system may be assumed.
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Affiliation(s)
- Antonia Matiszick
- Faculty VI - School of Medicine and Health Sciences, European Medical School, Oldenburg University.,Skin Cancer Center, Department of Dermatology, Allergology and Phlebology, Klinikum Bremerhaven
| | - Charlyn Völker
- Faculty VI - School of Medicine and Health Sciences, European Medical School, Oldenburg University.,Skin Cancer Center, Department of Dermatology, Allergology and Phlebology, Klinikum Bremerhaven
| | - Claus Garbe
- Section Dermatological Oncology, University Hospital for Dermatology, Eberhard Karls University, Tübingen
| | | | - Andrea Forschner
- Section Dermatological Oncology, University Hospital for Dermatology, Eberhard Karls University, Tübingen
| | - Gunnar Wagner
- Skin Cancer Center, Department of Dermatology, Allergology and Phlebology, Klinikum Bremerhaven
| | | | | | - Frank Schüssler
- Institute for Applied Photogrammetry and Geoinformatics, Jade Hochschule, Oldenburg
| | - Friedegund Meier
- Skin Tumor Center, National Center for Tumor Diseases, University Hospital Carl Gustav Carus at the Technical University Dresden
| | - Michael Max Sachse
- Skin Cancer Center, Department of Dermatology, Allergology and Phlebology, Klinikum Bremerhaven
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12
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Annunziata S, Laudicella R, Caobelli F, Pizzuto DA, Aimn Working Group Y. Clinical Value of PET/CT in Staging Melanoma and Potential New Radiotracers. Curr Radiopharm 2020; 13:6-13. [PMID: 31749438 DOI: 10.2174/1874471012666191015094620] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/02/2019] [Accepted: 07/17/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND 18F-FDG PET/CT has been suggested as an effective tool to stage patients affected by melanoma. In the latest years, new radiopharmaceuticals have been proposed and the use of hybrid PET/ceCT has emerged. OBJECTIVE To review recent evidence on the role of PET/CT in melanoma staging as well as its potential for future developments. METHODS A comprehensive computer literature search of PubMed/MEDLINE was carried out to find relevant published articles concerning the feasibility of PET/CT in patients with malignant melanoma. RESULTS Some recent studies about potentials and limitations of 18F-FDG PET/CT in staging melanoma, new PET radiotracers beyond 18F-FDG and application of hybrid PET/ceCT have been reviewed and discussed. CONCLUSION PET/CT plays an important role in the staging workup of patients affected by melanoma. New radiopharmaceuticals and hybrid PET/ceCT could improve the potential of this diagnostic tool in this field.
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Affiliation(s)
- Salvatore Annunziata
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Laudicella
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Messina ME, Italy
| | - Federico Caobelli
- Department of Nuclear Medicine, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Daniele A Pizzuto
- Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
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13
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El-Shourbagy KH, Mashaly EM, Khodair SA, Houseni MM, Abou Khadrah RS. PET/CT in restaging, prognosis, and recurrence in patients with malignant melanoma. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00276-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cutaneous malignant melanoma (CMM) is a highly aggressive tumor with high tendency of return despite complete surgical removal. It has a high risk of dissemination to regional lymph nodes and visceral organs. The prognosis is highly dependent on lymph node involvement and distant metastases. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. The purpose of the present study was to evaluate the role of integrated (PET/CT) in staging, restaging, prognosis, and prediction of recurrence in patients with malignant melanoma.
Results
Fifty malignant melanoma patients with age ranged from 28 to74 years (mean age 55.94 + 13.40 years) were 28 males (mean age 56.71 + 12.82) and 22 females (mean age 54.95 + 14.34). All our patients were histopathologically proven to have malignant melanoma. Twenty-one patients came for initial staging by 18F-FDG PET/CT. Their findings were compared with the reference standards and showed the sensitivity of 93.33%, specificity of 60%, and accuracy of 85.71% for primary staging. 18F-FDG PET/CT scan in 11 clinical suspicion patients of relapse after treatment showed the sensitivity of 100%, specificity of 66.66%, positive predictive value of 88.88%; negative predictive value of 100%; and accuracy of 90.90%. FDG-PET/CT of whole body scan in 18 cases of stage IV melanoma showed sensitivity of 100%, specificity of 66.66%, and overall accuracy of 94.44% for detection of distant metastases. SUVmean and SUVmax in all studied groups were significantly higher in true positive more than true negative or false-positive patients diagnosed by PET/CT with high sensitivity (82.88–100%).
Conclusion
PET/CT imaging enhanced diagnostic performance in detection of the primary malignancy, in follow-up of high-risk patients and patients with suspected or known local or distant recurrence, and in restaging of patients with known distant metastatic disease to assess tumor response.
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Abstract
We have previously reported increased glucose transporter 1 (GLUT1) expression in melanoma compared to benign nevi, associated with a significantly lower survival rate. GLUT1 upregulation was highly specific for distinguishing melanoma from benign nevi, yet poorly sensitive, likely because of expression of other GLUT isoforms. The purpose of this study was to evaluate GLUT2 and GLUT3, as melanoma biomarkers. A tissue microarray, consisting of 91 primary melanomas, 18 melanoma metastases, and 56 nevi, was examined using GLUT2 and GLUT3 immunohistochemistry. A semiquantitative scoring method was used to determine the percentage of positive tumor cells and staining intensity. GLUT2 was negative in all melanomas and benign nevi examined. Increased GLUT3 expression was more frequent in melanoma than in nevi (P < 0.0001), and in metastatic melanoma than in primary melanomas (P < 0.001). Of melanoma cases, 85.3% expressed either GLUT1 or GLUT3 or both, 39.4% of melanoma cases coexpressed GLUT1 and GLUT3, 17.4% of melanoma cases only expressed GLUT1, 28.4% of melanoma cases only expressed GLUT3, and 14.7% of melanoma cases were negative for both markers. Patients whose melanoma exhibited a high level of GLUT3 had significantly lower survival rates than those with low GLUT3 expression (P = 0.002). Evaluating both GLUT1 and GLUT3 increased the diagnostic value by increasing the sensitivity while the specificity remained high. In conclusion, GLUT2 was not expressed in melanocytes. GLUT3 expression was upregulated in melanoma compared with nevi, especially in those with worse prognosis. Similar to GLUT1, GLUT3 may serve as a useful diagnostic and prognostic marker.
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Shah D, Odedara P. Cutaneous malignant melanoma with rarest combination of prostatic and splenic metastases on fluorodeoxyglucose (FDG) positron emission tomography-computed tomography scan. World J Nucl Med 2020; 19:273-276. [PMID: 33354185 PMCID: PMC7745868 DOI: 10.4103/wjnm.wjnm_49_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/22/2019] [Indexed: 11/26/2022] Open
Abstract
Cutaneous malignant melanoma (MM) metastases to prostate and spleen are very rarely experienced in clinical setting. As per our knowledge, coexistence of prostate and splenic metastatic MM is not reported worldwide. We are presenting a case of 70-year-old male patients with biopsy and clinically proven case of multifocal cutaneous malignant melanomatous lesions having multiple metastatic lymph nodes and systemic metastases, including prostate and spleen. This is the first case reported worldwide having a combination of prostate and splenic metastases.
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Affiliation(s)
- Digish Shah
- Department of Nuclear Medicine and PET-CT, HCG Cancer Hospital, Department of Radiology, HCG Cancer Centre, Ahmedabad, Gujarat, India
| | - Prakash Odedara
- Department of Nuclear Medicine and PET-CT, HCG Cancer Hospital, Department of Radiology, HCG Cancer Centre, Ahmedabad, Gujarat, India
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Abstract
With the emergence of new therapeutic modalities, the diagnosis of melanoma at the earliest practicable stage has become more important for improving the survival of patients. We developed a positron emission tomography (PET) imaging probe, N-(2-(dimethylamino)ethyl)-5-[18F]fluoropicolinamide ([18F]DMPY2) and evaluated diagnostic performance in animal models. [18F]DMPY2 PET exhibited excellent performance in detecting primary and metastatic melanomas, demonstrating strong/prolonged tumoral uptake and rapid background clearance. This suggests that this radiotracer could be used as a novel PET imaging agent to obtain outstanding image quality in the diagnosis of melanoma. This is the pioneering report of pyridine-based benzamide derivative with reduced alkyl chains in the amine residue and ultrasensitive detection of melanoma lesions in living subjects compared to conventional PET imaging agents. Malignant melanoma has one of the highest mortality rates of any cancer because of its aggressive nature and high metastatic potential. Clinical staging of the disease at the time of diagnosis is very important for the prognosis and outcome of melanoma treatment. In this study, we designed and synthesized the 18F-labeled pyridine-based benzamide derivatives N-(2-(dimethylamino)ethyl)-5-[18F]fluoropicolinamide ([18F]DMPY2) and N-(2-(dimethylamino)ethyl)-6-[18F]fluoronicotinamide ([18F]DMPY3) to detect primary and metastatic melanoma at an early stage and evaluated their performance in this task. [18F]DMPY2 and [18F]DMPY3 were synthesized by direct radiofluorination of the bromo precursor, and radiochemical yields were ∼15–20%. Cell uptakes of [18F]DMPY2 and [18F]DMPY3 were >103-fold and 18-fold higher, respectively, in B16F10 (mouse melanoma) cells than in negative control cells. Biodistribution studies revealed strong tumor uptake and retention of [18F]DMPY2 (24.8% injected dose per gram of tissue [ID/g] at 60 min) and [18F]DMPY3 (11.7%ID/g at 60 min) in B16F10 xenografts. MicroPET imaging of both agents demonstrated strong tumoral uptake/retention and rapid washout, resulting in excellent tumor-to-background contrast in B16F10 xenografts. In particular, [18F]DMPY2 clearly visualized almost all metastatic lesions in lung and lymph nodes, with excellent image quality. [18F]DMPY2 demonstrated a significantly higher tumor-to-liver ratio than [18F]fluorodeoxyglucose ([18F]FDG) and the previously reported benzamide tracers N-[2-(diethylamino)-ethyl]-5-[18F]fluoropicolinamide ([18F]P3BZA) and N-[2-(diethylamino)-ethyl]-4-[18F]fluorobenzamide ([18F]FBZA) in B16F10-bearing or SK-MEL-3 (human melanoma)-bearing mice. In conclusion, [18F]DMPY2 might have strong potential for the diagnosis of early stage primary and metastatic melanoma using positron emission tomography (PET).
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Yılmaz H, Orhan E, Şahin E, Olguner AA, Arpacı E. Efficacy of positron emission tomography and computed tomography in clinical staging of cutaneous malignant melanoma. Dermatol Ther 2020; 33:e13304. [PMID: 32160381 DOI: 10.1111/dth.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 11/29/2022]
Abstract
Accurate staging is very important for determining the prognosis and appropriate treatment for malignant melanoma (MM). The aim of this study is to determine the effectiveness of positron emission tomography and computed tomography (PET/CT) imaging in staging MM. Patients diagnosed with MM who then underwent PET/CT metastasis before treatment were assessed retrospectively. For each patient, the following variables were recorded: Breslow thickness, Clark's level, number of mitoses, the presence of ulceration detected in the pathology report, and the presence of lymph nodes and/or distant metastases detected by PET/CT. The pathology and PET/CT reports of 139 patients (79 female and 60 male) were retrospectively evaluated for staging after MM diagnosis. Patients with a Breslow thickness greater than 3.4 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with regional lymph node metastasis after PET/CT scans. Patients with Breslow thickness greater than 2.85 mm and Clark's level of 4 to 5 were found to be statistically significantly higher with distant metastasis after PET/CT scan. The results of our study suggest that PET/CT imaging for metastasis scanning, starting with T2 patients, may be used in MM staging to reduce the need for sentinel lymph node (SLN) biopsy and lymph node dissection.
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Affiliation(s)
- Harun Yılmaz
- Department of Plastic Surgery, Gaziantep University, School of Medicine, Gaziantep, Turkey
| | - Erkan Orhan
- Department of Plastic Surgery, Gaziantep University, School of Medicine, Gaziantep, Turkey
| | - Ertan Şahin
- Department of Nuclear Medicine, Gaziantep University, School of Medicine, Gaziantep, Turkey
| | - Anıl A Olguner
- Department of Plastic Surgery, Gaziantep University, School of Medicine, Gaziantep, Turkey
| | - Enver Arpacı
- Department of Plastic Surgery, Başkent University, School of Medicine, Konya, Turkey
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Wichmann CW, Goh YW, Parslow AC, Rigopoulos A, Guo N, Scott AM, Ackermann U, White JM. Synthesis and validation of [ 18F]mBPET-1, a fluorine-18 labelled mTOR inhibitor derivative based on a benzofuran backbone. EJNMMI Radiopharm Chem 2020; 5:3. [PMID: 31974638 PMCID: PMC6977806 DOI: 10.1186/s41181-020-0089-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022] Open
Abstract
Background Targeted therapy of HER2 positive breast cancer has led to clinical success in some cases with primary and secondary resistance being major obstacles. Due to the substantial involvement of mTOR kinase in cell growth and proliferation pathways it is now targeted in combination treatments to counteract HER2 targeted therapy resistance. However, the selection of receptive patient populations for a specific drug combination is crucial. This work aims to develop a molecular probe capable of identifying patients with tumour populations which are receptive to RAD001 combination therapy. Based on the structure of a mTOR inhibitor specific for mTORC1, we designed, synthesised and characterised a novel benzofuran based molecular probe which suits late stage fluorination via Click chemistry. Results Synthesis of the alkyne precursor 5 proceeded in 27.5% yield over 7 linear steps. Click derivatisation gave the non-radioactive standard in 25% yield. Radiosynthesis of [18F]1-((1-(2-Fluoroethyl)-1H-1,2,3-triazol-4-yl) methyl)-4-((5-methoxy-2-phenylbenzofuran-4-yl) methyl) piperazine ([18F]mBPET-1) proceeded over two steps which were automated on an iPhase FlexLab synthesis module. In the first step, 2-[18F]fluoroethylazide ([18F]6) was produced, purified by automated distillation in 60% non-decay-corrected yield and subjected to Click conditions with 5. Semi-preparative RP-HPLC purification and reformulation gave [18F]mBPET-1 in 40% ± 5% (n = 6) overall RCY with a process time of 90 min. Radiochemical purity was ≥99% at end of synthesis (EOS) and ≥ 98% after 4 h at room temperature. Molar activities ranged from typically 24.8 GBq/μmol (EOS) to a maximum of 78.6 GBq/μmol (EOS). Lipophilicity of [18F]mBPET-1 was determined at pH 7.4 (logD7.4 = 0.89). [18F]mBPET-1 showed high metabolic stability when incubated with mouse S9 liver fractions which resulted in a 0.8% drop in radiochemical purity after 3 h. Cell uptake assays showed 1.3–1.9-fold increased uptake of the [18F]mBPET-1 in RAD001 sensitive compared to insensitive cells across a panel of 4 breast cancer cell lines. Conclusion Molecular targeting of mTOR with [18F]mBPET-1 distinguishes mTOR inhibitor sensitive and insensitive cell lines. Future studies will explore the ability of [18F]mBPET-1 to predict response to mTOR inhibitor treatment in in vivo models.
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Affiliation(s)
- Christian W Wichmann
- The University of Melbourne, Parkville, VIC, 3010, Australia. .,Department of Molecular Imaging and Therapy, Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia. .,Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia. .,School of Cancer Medicine, La Trobe University, Plenty Road & Kingsbury Drive, Bundoora, VIC, 3086, Australia.
| | - Yit Wooi Goh
- Department of Molecular Imaging and Therapy, Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Adam C Parslow
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Plenty Road & Kingsbury Drive, Bundoora, VIC, 3086, Australia
| | - Angela Rigopoulos
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Plenty Road & Kingsbury Drive, Bundoora, VIC, 3086, Australia
| | - Nancy Guo
- Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia
| | - Andrew M Scott
- The University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Molecular Imaging and Therapy, Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Plenty Road & Kingsbury Drive, Bundoora, VIC, 3086, Australia
| | - Uwe Ackermann
- The University of Melbourne, Parkville, VIC, 3010, Australia.,Department of Molecular Imaging and Therapy, Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, VIC, 3084, Australia.,School of Cancer Medicine, La Trobe University, Plenty Road & Kingsbury Drive, Bundoora, VIC, 3086, Australia
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Nuclear Medicine Imaging Techniques in Melanoma. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18F-Labeled Cyclized α-Melanocyte-Stimulating Hormone Derivatives for Imaging Human Melanoma Xenograft with Positron Emission Tomography. Sci Rep 2019; 9:13575. [PMID: 31537869 PMCID: PMC6753210 DOI: 10.1038/s41598-019-50014-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/04/2019] [Indexed: 12/22/2022] Open
Abstract
Since metastatic melanoma is deadly, early diagnosis thereof is crucial for managing the disease. We recently developed α-melanocyte-stimulating hormone (αMSH) derivatives, [68Ga]Ga-CCZ01048 and [18F]CCZ01064, that target the melanocortin 1 receptor (MC1R) for mouse melanoma imaging. In this study, we aim to evaluate [18F]CCZ01064 as well as a novel dual-ammoniomethyl-trifluoroborate (AmBF3) derivative, [18F]CCZ01096, for targeting human melanoma xenograft using μPET imaging. The peptides were synthesized on solid phase using Fmoc chemistry. Radiolabeling was achieved in a one-step 18F-19F isotope-exchange reaction. μPET imaging and biodistribution studies were performed in NSG mice bearing SK-MEL-1 melanoma xenografts. The MC1R density on the SK-MEL-1 cell line was determined to be 972 ± 154 receptors/cell (n = 4) via saturation assays. Using [18F]CCZ01064, moderate tumor uptake (3.05 ± 0.47%ID/g) and image contrast were observed at 2 h post-injection. Molar activity was determined to play a key role. CCZ01096 with two AmBF3 motifs showed comparable sub-nanomolar binding affinity to MC1R and much higher molar activity. This resulted in improved tumor uptake (6.46 ± 1.42%ID/g) and image contrast (tumor-to-blood and tumor-to-muscle ratios were 30.6 ± 5.7 and 85.7 ± 11.3, respectively) at 2 h post-injection. [18F]CCZ01096 represents a promising αMSH-based μPET imaging agent for human melanoma and warrants further investigation for potential clinical translation.
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21
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Dinnes J, Ferrante di Ruffano L, Takwoingi Y, Cheung ST, Nathan P, Matin RN, Chuchu N, Chan SA, Durack A, Bayliss SE, Gulati A, Patel L, Davenport C, Godfrey K, Subesinghe M, Traill Z, Deeks JJ, Williams HC. Ultrasound, CT, MRI, or PET-CT for staging and re-staging of adults with cutaneous melanoma. Cochrane Database Syst Rev 2019; 7:CD012806. [PMID: 31260100 PMCID: PMC6601698 DOI: 10.1002/14651858.cd012806.pub2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Melanoma is one of the most aggressive forms of skin cancer, with the potential to metastasise to other parts of the body via the lymphatic system and the bloodstream. Melanoma accounts for a small percentage of skin cancer cases but is responsible for the majority of skin cancer deaths. Various imaging tests can be used with the aim of detecting metastatic spread of disease following a primary diagnosis of melanoma (primary staging) or on clinical suspicion of disease recurrence (re-staging). Accurate staging is crucial to ensuring that patients are directed to the most appropriate and effective treatment at different points on the clinical pathway. Establishing the comparative accuracy of ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT imaging for detection of nodal or distant metastases, or both, is critical to understanding if, how, and where on the pathway these tests might be used. OBJECTIVES Primary objectivesWe estimated accuracy separately according to the point in the clinical pathway at which imaging tests were used. Our objectives were:• to determine the diagnostic accuracy of ultrasound or PET-CT for detection of nodal metastases before sentinel lymph node biopsy in adults with confirmed cutaneous invasive melanoma; and• to determine the diagnostic accuracy of ultrasound, CT, MRI, or PET-CT for whole body imaging in adults with cutaneous invasive melanoma:○ for detection of any metastasis in adults with a primary diagnosis of melanoma (i.e. primary staging at presentation); and○ for detection of any metastasis in adults undergoing staging of recurrence of melanoma (i.e. re-staging prompted by findings on routine follow-up).We undertook separate analyses according to whether accuracy data were reported per patient or per lesion.Secondary objectivesWe sought to determine the diagnostic accuracy of ultrasound, CT, MRI, or PET-CT for whole body imaging (detection of any metastasis) in mixed or not clearly described populations of adults with cutaneous invasive melanoma.For study participants undergoing primary staging or re-staging (for possible recurrence), and for mixed or unclear populations, our objectives were:• to determine the diagnostic accuracy of ultrasound, CT, MRI, or PET-CT for detection of nodal metastases;• to determine the diagnostic accuracy of ultrasound, CT, MRI, or PET-CT for detection of distant metastases; and• to determine the diagnostic accuracy of ultrasound, CT, MRI, or PET-CT for detection of distant metastases according to metastatic site. SEARCH METHODS We undertook a comprehensive search of the following databases from inception up to August 2016: Cochrane Central Register of Controlled Trials; MEDLINE; Embase; CINAHL; CPCI; Zetoc; Science Citation Index; US National Institutes of Health Ongoing Trials Register; NIHR Clinical Research Network Portfolio Database; and the World Health Organization International Clinical Trials Registry Platform. We studied reference lists as well as published systematic review articles. SELECTION CRITERIA We included studies of any design that evaluated ultrasound (with or without the use of fine needle aspiration cytology (FNAC)), CT, MRI, or PET-CT for staging of cutaneous melanoma in adults, compared with a reference standard of histological confirmation or imaging with clinical follow-up of at least three months' duration. We excluded studies reporting multiple applications of the same test in more than 10% of study participants. DATA COLLECTION AND ANALYSIS Two review authors independently extracted all data using a standardised data extraction and quality assessment form (based on the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2)). We estimated accuracy using the bivariate hierarchical method to produce summary sensitivities and specificities with 95% confidence and prediction regions. We undertook analysis of studies allowing direct and indirect comparison between tests. We examined heterogeneity between studies by visually inspecting the forest plots of sensitivity and specificity and summary receiver operating characteristic (ROC) plots. Numbers of identified studies were insufficient to allow formal investigation of potential sources of heterogeneity. MAIN RESULTS We included a total of 39 publications reporting on 5204 study participants; 34 studies reporting data per patient included 4980 study participants with 1265 cases of metastatic disease, and seven studies reporting data per lesion included 417 study participants with 1846 potentially metastatic lesions, 1061 of which were confirmed metastases. The risk of bias was low or unclear for all domains apart from participant flow. Concerns regarding applicability of the evidence were high or unclear for almost all domains. Participant selection from mixed or not clearly defined populations and poorly described application and interpretation of index tests were particularly problematic.The accuracy of imaging for detection of regional nodal metastases before sentinel lymph node biopsy (SLNB) was evaluated in 18 studies. In 11 studies (2614 participants; 542 cases), the summary sensitivity of ultrasound alone was 35.4% (95% confidence interval (CI) 17.0% to 59.4%) and specificity was 93.9% (95% CI 86.1% to 97.5%). Combining pre-SLNB ultrasound with FNAC revealed summary sensitivity of 18.0% (95% CI 3.58% to 56.5%) and specificity of 99.8% (95% CI 99.1% to 99.9%) (1164 participants; 259 cases). Four studies demonstrated lower sensitivity (10.2%, 95% CI 4.31% to 22.3%) and specificity (96.5%,95% CI 87.1% to 99.1%) for PET-CT before SLNB (170 participants, 49 cases). When these data are translated to a hypothetical cohort of 1000 people eligible for SLNB, 237 of whom have nodal metastases (median prevalence), the combination of ultrasound with FNAC potentially allows 43 people with nodal metastases to be triaged directly to adjuvant therapy rather than having SLNB first, at a cost of two people with false positive results (who are incorrectly managed). Those with a false negative ultrasound will be identified on subsequent SLNB.Limited test accuracy data were available for whole body imaging via PET-CT for primary staging or re-staging for disease recurrence, and none evaluated MRI. Twenty-four studies evaluated whole body imaging. Six of these studies explored primary staging following a confirmed diagnosis of melanoma (492 participants), three evaluated re-staging of disease following some clinical indication of recurrence (589 participants), and 15 included mixed or not clearly described population groups comprising participants at a number of different points on the clinical pathway and at varying stages of disease (1265 participants). Results for whole body imaging could not be translated to a hypothetical cohort of people due to paucity of data.Most of the studies (6/9) of primary disease or re-staging of disease considered PET-CT, two in comparison to CT alone, and three studies examined the use of ultrasound. No eligible evaluations of MRI in these groups were identified. All studies used histological reference standards combined with follow-up, and two included FNAC for some participants. Observed accuracy for detection of any metastases for PET-CT was higher for re-staging of disease (summary sensitivity from two studies: 92.6%, 95% CI 85.3% to 96.4%; specificity: 89.7%, 95% CI 78.8% to 95.3%; 153 participants; 95 cases) compared to primary staging (sensitivities from individual studies ranged from 30% to 47% and specificities from 73% to 88%), and was more sensitive than CT alone in both population groups, but participant numbers were very small.No conclusions can be drawn regarding routine imaging of the brain via MRI or CT. AUTHORS' CONCLUSIONS Review authors found a disappointing lack of evidence on the accuracy of imaging in people with a diagnosis of melanoma at different points on the clinical pathway. Studies were small and often reported data according to the number of lesions rather than the number of study participants. Imaging with ultrasound combined with FNAC before SLNB may identify around one-fifth of those with nodal disease, but confidence intervals are wide and further work is needed to establish cost-effectiveness. Much of the evidence for whole body imaging for primary staging or re-staging of disease is focused on PET-CT, and comparative data with CT or MRI are lacking. Future studies should go beyond diagnostic accuracy and consider the effects of different imaging tests on disease management. The increasing availability of adjuvant therapies for people with melanoma at high risk of disease spread at presentation will have a considerable impact on imaging services, yet evidence for the relative diagnostic accuracy of available tests is limited.
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Affiliation(s)
- Jacqueline Dinnes
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | | | - Yemisi Takwoingi
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Seau Tak Cheung
- Dudley Hospitals Foundation Trust, Corbett HospitalDepartment of DermatologyWicarage RoadStourbridgeUKDY8 4JB
| | - Paul Nathan
- Mount Vernon HospitalMount Vernon Cancer CentreRickmansworth RoadNorthwoodUKHA6 2RN
| | - Rubeta N Matin
- Churchill HospitalDepartment of DermatologyOld RoadHeadingtonOxfordUKOX3 7LE
| | - Naomi Chuchu
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Sue Ann Chan
- City HospitalBirmingham Skin CentreDudley RdBirminghamUKB18 7QH
| | - Alana Durack
- Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation TrustDermatologyHills RoadCambridgeUKCB2 0QQ
| | - Susan E Bayliss
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Abha Gulati
- Barts Health NHS TrustDepartment of DermatologyWhitechapelLondonUKE11BB
| | - Lopa Patel
- Royal Stoke HospitalPlastic SurgeryStoke‐on‐TrentStaffordshireUKST4 6QG
| | - Clare Davenport
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Kathie Godfrey
- The University of Nottinghamc/o Cochrane Skin GroupNottinghamUK
| | - Manil Subesinghe
- King's College LondonCancer Imaging, School of Biomedical Engineering & Imaging SciencesLondonUK
| | - Zoe Traill
- Oxford University Hospitals NHS TrustChurchill Hospital Radiology DepartmentOxfordUK
| | - Jonathan J Deeks
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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22
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Berger DMS, van Veen MM, Madu MF, van Akkooi ACJ, Vogel WV, Balm AJM, Klop WMC. Parotidectomy in patients with head and neck cutaneous melanoma with cervical lymph node involvement. Head Neck 2019; 41:2264-2270. [PMID: 30762921 DOI: 10.1002/hed.25670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/21/2018] [Accepted: 01/15/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Parotidectomy in melanoma of the coronal scalp and face with clinically involved cervical lymph node metastasis is based on predicted cervical lymphatic drainage described by O'Brien. METHODS In total, 40 parotidectomies with en bloc therapeutic neck dissection were retrospectively analyzed. RESULTS Lymphatic spread of melanoma to the parotid lymph nodes was observed in 10 of 40 specimens (25%). Eight of the 10 parotid-positive patients developed a recurrence vs 17 of the 30 parotid-negative patients (P = 0.28). There were no differences in overall survival, melanoma-specific survival, and disease-free survival between the parotid-positive and parotid-negative patients. CONCLUSION Although in this series no survival differences were found, parotidectomy still merits a sustained role in therapeutic neck dissection procedures to improve regional control and to prevent facial nerve damage after surgery for a second relapse from occult metastases in the parotid.
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Affiliation(s)
- Danique M S Berger
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Martinus M van Veen
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Max F Madu
- Department of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Alexander C J van Akkooi
- Department of Surgical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Wouter V Vogel
- Department of Nuclear Medicine, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Radiotherapy, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Alfons J M Balm
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Willem M C Klop
- Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Department of Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
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Zhang B. Molecular Imaging and Targeted Therapy for Malignant Melanoma. NUCLEAR MEDICINE IN ONCOLOGY 2019:129-138. [DOI: 10.1007/978-981-13-7458-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Swetter SM, Tsao H, Bichakjian CK, Curiel-Lewandrowski C, Elder DE, Gershenwald JE, Guild V, Grant-Kels JM, Halpern AC, Johnson TM, Sober AJ, Thompson JA, Wisco OJ, Wyatt S, Hu S, Lamina T. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol 2018; 80:208-250. [PMID: 30392755 DOI: 10.1016/j.jaad.2018.08.055] [Citation(s) in RCA: 339] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
The incidence of primary cutaneous melanoma continues to increase each year. Melanoma accounts for the majority of skin cancer-related deaths, but treatment is usually curative following early detection of disease. In this American Academy of Dermatology clinical practice guideline, updated treatment recommendations are provided for patients with primary cutaneous melanoma (American Joint Committee on Cancer stages 0-IIC and pathologic stage III by virtue of a positive sentinel lymph node biopsy). Biopsy techniques for a lesion that is clinically suggestive of melanoma are reviewed, as are recommendations for the histopathologic interpretation of cutaneous melanoma. The use of laboratory, molecular, and imaging tests is examined in the initial work-up of patients with newly diagnosed melanoma and for follow-up of asymptomatic patients. With regard to treatment of primary cutaneous melanoma, recommendations for surgical margins and the concepts of staged excision (including Mohs micrographic surgery) and nonsurgical treatments for melanoma in situ, lentigo maligna type (including topical imiquimod and radiation therapy), are updated. The role of sentinel lymph node biopsy as a staging technique for cutaneous melanoma is described, with recommendations for its use in clinical practice. Finally, current data regarding pregnancy and melanoma, genetic testing for familial melanoma, and management of dermatologic toxicities related to novel targeted agents and immunotherapies for patients with advanced disease are summarized.
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Affiliation(s)
- Susan M Swetter
- Department of Dermatology, Stanford University Medical Center and Cancer Institute, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
| | - Hensin Tsao
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Wellman Center for Photomedicine, Boston, Massachusetts
| | - Christopher K Bichakjian
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Clara Curiel-Lewandrowski
- Division of Dermatology, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona
| | - David E Elder
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pathology, University of Connecticut Health Center, Farmington, Connecticut; Department of Pediatrics, University of Connecticut Health Center, Farmington, Connecticut
| | - Allan C Halpern
- Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Timothy M Johnson
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan; Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Arthur J Sober
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - John A Thompson
- Division of Oncology, University of Washington, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington
| | - Oliver J Wisco
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | | | - Shasa Hu
- Department of Dermatology, University of Miami Health System, Miami, Florida
| | - Toyin Lamina
- American Academy of Dermatology, Rosemont, Illinois
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Zhang C, Lin KS, Bénard F. Molecular Imaging and Radionuclide Therapy of Melanoma Targeting the Melanocortin 1 Receptor. Mol Imaging 2018; 16:1536012117737919. [PMID: 29182034 PMCID: PMC5714078 DOI: 10.1177/1536012117737919] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Melanoma is a deadly disease at late metastatic stage, and early diagnosis and accurate staging remain the key aspects for managing melanoma. The melanocortin 1 receptor (MC1 R) is overexpressed in primary and metastatic melanomas, and its endogenous ligand, the α-melanocyte-stimulating hormone (αMSH), has been extensively studied for the development of MC1 R-targeted molecular imaging and therapy of melanoma. Natural αMSH is not well suited for this purpose due to low stability in vivo. Unnatural amino acid substitutions substantially stabilized the peptide, while cyclization via lactam bridge and metal coordination further improved binding affinity and stability. In this study, we summarized the development and the in vitro and in vivo characteristics of the radiolabeled αMSH analogues, including 99mTc-, 111In-, 67 Ga-, or 125I-labeled αMSH analogues for imaging with single-photon emission computed tomography; 68Ga-, 64Cu-, or 18F-labeled αMSH analogues for imaging with positron emission tomography; and 188Re-, 177Lu-, 90Y-, or 212Pb-labeled αMSH analogues for radionuclide therapy. These radiolabeled αMSH analogues showed promising results with high tumor uptake and rapid normal tissue activity clearance in the preclinical model of B16F1 and B16F10 mouse melanomas. These results highlight the potential of using radiolabeled αMSH analogues in clinical applications for molecular imaging and radionuclide therapy of melanoma.
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Affiliation(s)
- Chengcheng Zhang
- 1 Department of Molecular Oncology, BC Cancer, Vancouver, British Columbia, Canada
| | - Kuo-Shyan Lin
- 1 Department of Molecular Oncology, BC Cancer, Vancouver, British Columbia, Canada.,2 Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - François Bénard
- 1 Department of Molecular Oncology, BC Cancer, Vancouver, British Columbia, Canada.,2 Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
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Perissinotti A, Rietbergen DDD, Vidal-Sicart S, Riera AA, Olmos RA. Melanoma & nuclear medicine: new insights & advances. Melanoma Manag 2018; 5:MMT06. [PMID: 30190932 PMCID: PMC6122522 DOI: 10.2217/mmt-2017-0022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 03/29/2018] [Indexed: 12/16/2022] Open
Abstract
The contribution of nuclear medicine to management of melanoma patients is increasing. In intermediate-thickness N0 melanomas, lymphoscintigraphy provides a roadmap for sentinel node biopsy. With the introduction of single-photon emission computed tomography images with integrated computed tomography (SPECT/CT), 3D anatomic environments for accurate surgical planning are now possible. Sentinel node identification in intricate anatomical areas (pelvic cavity, head/neck) has been improved using hybrid radioactive/fluorescent tracers, preoperative lymphoscintigraphy and SPECT/CT together with modern intraoperative portable imaging technologies for surgical navigation (free-hand SPECT, portable gamma cameras). Furthermore, PET/CT today provides 3D roadmaps to resect 18F-fluorodeoxyglucose-avid melanoma lesions. Simultaneously, in advanced-stage melanoma and recurrences, 18F-fluorodeoxyglucose-PET/CT is useful in clinical staging and treatment decision as well as in the evaluation of therapy response. In this article, we review new insights and recent nuclear medicine advances in the management of melanoma patients.
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Affiliation(s)
- Andrés Perissinotti
- Department of Nuclear Medicine, Hospital Clinic, C/Villarroel 170, 08036 Barcelona, Spain
| | - Daphne DD Rietbergen
- Nuclear Medicine Section & Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Sergi Vidal-Sicart
- Department of Nuclear Medicine, Hospital Clinic, C/Villarroel 170, 08036 Barcelona, Spain
| | - Ana A Riera
- Department of Nuclear Medicine, Hospital Universitario Nuestra Señora de la Candelaria, Carretera del Rosario 145, 08010 SC de Tenerife, Spain
| | - Renato A Valdés Olmos
- Nuclear Medicine Section & Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands
- Department of Nuclear Medicine, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Cegla P, Spychala A, Marszalek A, Wierzchoslawska E, Cholewinski W. Atypical spleen tuberculosis in a melanoma patient accidentally detected during a 18F-FDG PET/CT study: Case report. Mol Clin Oncol 2018; 8:89-92. [PMID: 29399349 DOI: 10.3892/mco.2017.1498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 11/07/2017] [Indexed: 11/06/2022] Open
Abstract
The present study, discussed a rare case of a 50-year-old woman who was treated for malignant melanoma and underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) examination for evaluation of disease. 18F-FDG-PET/CT examination was performed from the top of the head down to the knee using a Gemini TF PET/CT scanner 60 min following intravenous injection of radiotracer with mean activity of 364±75 MBq. Previous performed laboratory test and clinical examination was irrelevant. By abdominal ultrasound no abnormalities in abdominal organs beside the liver cyst were found. The 18F-FDG PET/CT exam showed an increased glucose metabolism in the anterior pole of the spleen, which was considered as melanoma metastasis. Splenectomy was performed and histopathology examination tuberculous lesion in the spleen was revealed. Histopathology examination showed epithelioid granuloma and in correlation with the patient's history allowed to establish tuberculous-like lesions in the spleen. In the present study, authors used 18F-FDG PET/CT examination to detect the melanoma metastasis of a 50-year-old woman, and found that abnormal focal accumulation of radiotracer with limited cancer specificity in PET/CT examination in cancer patients should not be unambiguously taken as a metastatic lesion.
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Affiliation(s)
- Paulina Cegla
- Department of Nuclear Medicine, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Arkadiusz Spychala
- Department of Surgical Oncology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Andrzej Marszalek
- Department of Clinical Pathology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Ewa Wierzchoslawska
- Department of Radiology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Witold Cholewinski
- Chair and Department of Electroradiology, Medical University in Poznan, 61-701 Poznan, Poland
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Utility of whole-body (head-to-toe) PET/CT in the evaluation of melanoma and sarcoma patients. Nucl Med Commun 2018; 39:68-73. [DOI: 10.1097/mnm.0000000000000778] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wei W, Ehlerding EB, Lan X, Luo Q, Cai W. PET and SPECT imaging of melanoma: the state of the art. Eur J Nucl Med Mol Imaging 2018; 45:132-150. [PMID: 29085965 PMCID: PMC5700861 DOI: 10.1007/s00259-017-3839-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/18/2017] [Indexed: 12/12/2022]
Abstract
Melanoma represents the most aggressive form of skin cancer, and its incidence continues to rise worldwide. 18F-FDG PET imaging has transformed diagnostic nuclear medicine and has become an essential component in the management of melanoma, but still has its drawbacks. With the rapid growth in the field of nuclear medicine and molecular imaging, a variety of promising probes that enable early diagnosis and detection of melanoma have been developed. The substantial preclinical success of melanin- and peptide-based probes has recently resulted in the translation of several radiotracers to clinical settings for noninvasive imaging and treatment of melanoma in humans. In this review, we focus on the latest developments in radiolabeled molecular imaging probes for melanoma in preclinical and clinical settings, and discuss the challenges and opportunities for future development.
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Affiliation(s)
- Weijun Wei
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600# Yishan Road, Shanghai, 200233, China
- Department of Radiology, University of Wisconsin-Madison, Room 7137, 1111 Highland Avenue, Madison, WI, 53705-2275, USA
| | - Emily B Ehlerding
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China.
| | - Quanyong Luo
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600# Yishan Road, Shanghai, 200233, China.
| | - Weibo Cai
- Department of Radiology, University of Wisconsin-Madison, Room 7137, 1111 Highland Avenue, Madison, WI, 53705-2275, USA.
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705, USA.
- University of Wisconsin Carbone Cancer Center, Madison, WI, 53705, USA.
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Plouznikoff N, Arsenault F. Factors Linked to the Metastatic Spread of Malignant Cutaneous Melanoma to the Lower Extremities in a Retrospective 18F-FDG PET/CT Cohort. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.clsc.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Dinnes J, Saleh D, Newton-Bishop J, Cheung ST, Nathan P, Matin RN, Chuchu N, Bayliss SE, Takwoingi Y, Davenport C, Godfrey K, O'Sullivan C, Deeks JJ, Williams HC. Tests to assist in the staging of cutaneous melanoma: a generic protocol. Hippokratia 2017. [DOI: 10.1002/14651858.cd012806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Jacqueline Dinnes
- University of Birmingham; Institute of Applied Health Research; Birmingham UK B15 2TT
| | - Daniel Saleh
- Newcastle Hospitals NHS Trust, Royal Victoria Infirmary; Newcastle Hospitals; Newcastle UK
| | - Julia Newton-Bishop
- University of Leeds; Section of Epidemiology and Biostatistics; St James's Hospital Leeds UK LS9 7TF
| | - Seau Tak Cheung
- Dudley Hospitals Foundation Trust, Corbett Hospital; Department of Dermatology; Wicarage Road Stourbridge UK DY8 4JB
| | - Paul Nathan
- Mount Vernon Hospital; Mount Vernon Cancer Centre; Rickmansworth Road Northwood UK HA6 2RN
| | - Rubeta N Matin
- Churchill Hospital; Department of Dermatology; Old Road Headington Oxford UK OX3 7LJ
| | - Naomi Chuchu
- University of Birmingham; Institute of Applied Health Research; Birmingham UK B15 2TT
| | - Susan E Bayliss
- University of Birmingham; Institute of Applied Health Research; Birmingham UK B15 2TT
| | - Yemisi Takwoingi
- University of Birmingham; Institute of Applied Health Research; Birmingham UK B15 2TT
| | - Clare Davenport
- University of Birmingham; Institute of Applied Health Research; Birmingham UK B15 2TT
| | - Kathie Godfrey
- The University of Nottingham; c/o Cochrane Skin Group; Nottingham UK
| | | | - Jonathan J Deeks
- University of Birmingham; Institute of Applied Health Research; Birmingham UK B15 2TT
| | - Hywel C Williams
- The University of Nottingham; Centre of Evidence Based Dermatology; Queen's Medical Centre Derby Road Nottingham UK NG7 2UH
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Koskivuo I, Kemppainen J, Giordano S, Seppänen M, Veräjänkorva E, Vihinen P, Minn H. Whole body PET/CT in the follow-up of asymptomatic patients with stage IIB-IIIB cutaneous melanoma . Acta Oncol 2016; 55:1355-1359. [PMID: 27553064 DOI: 10.1080/0284186x.2016.1213879] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/04/2016] [Accepted: 07/11/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Whole body positron emission tomography (PET)/computed tomography (CT) is a sensitive imaging technique in patients with metastatic melanoma, but its role in the follow-up of asymptomatic high-risk patients is unclear. The aim was to study the role of PET/CT as a routine surveillance imaging tool in asymptomatic high-risk patients at the early stage of follow-up combined with a sufficient follow-up over several years. MATERIAL AND METHODS A total of 110 asymptomatic patients with clinically local American Joint Committee on Cancer (AJCC) stage IIB-IIIB melanoma underwent routine whole body PET/CT scanning after a mean interval of seven months after initial surgery. Clinical data were retrospectively analyzed after a median follow-up time of 4.6 years. RESULTS Recurrent melanoma was detected in 45 patients (41%) and 36 (33%) died of melanoma. In 11 asymptomatic patients (10%) occult disease was detected with a single PET/CT. In seven of these patients (64%), positive PET/CT finding had major influence in treatment decisions. Four patients underwent surgical metastasectomy and two of them remained disease-free. In 34 patients (31%) PET/CT revealed no disease, but recurrence was detected at a median time of 19 months after negative PET/CT scan. In 50 patients (45%) PET/CT finding was true negative. In 15 patients (14%) scan was false positive leading to additional management or repetitive imagings. CONCLUSION A single PET/CT could detect 24% of all recurrences in asymptomatic melanoma patients at the early stage of follow-up, but an earlier detection of occult metastases did not improve survival.
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Affiliation(s)
- I Koskivuo
- a Department of Plastic and General Surgery , Turku University Hospital and University of Turku , Turku , Finland
| | - J Kemppainen
- b Turku PET Centre, Turku University Hospital and University of Turku , Turku , Finland
- c Department of Clinical Physiology and Nuclear Medicine , Turku University Hospital and University of Turku , Turku , Finland
| | - S Giordano
- a Department of Plastic and General Surgery , Turku University Hospital and University of Turku , Turku , Finland
| | - M Seppänen
- b Turku PET Centre, Turku University Hospital and University of Turku , Turku , Finland
- c Department of Clinical Physiology and Nuclear Medicine , Turku University Hospital and University of Turku , Turku , Finland
| | - E Veräjänkorva
- a Department of Plastic and General Surgery , Turku University Hospital and University of Turku , Turku , Finland
| | - P Vihinen
- d Department of Oncology , Turku University Hospital and University of Turku , Turku , Finland
| | - H Minn
- d Department of Oncology , Turku University Hospital and University of Turku , Turku , Finland
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18F-FDG-PET/CT in the Staging and Management of Melanoma: A Prospective Multicenter Ontario PET Registry Study. Clin Nucl Med 2016; 41:189-93. [PMID: 26447374 DOI: 10.1097/rlu.0000000000000996] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The Ontario PET Registry was established to provide evidence on the clinical impact of 18-FDG-PET/CT (PET) imaging to inform Ontario Health Insurance Plan funding decisions. The melanoma registry assessed the use of melanoma staging by PET in advanced or high-risk melanoma as a useful adjunct to clinical and standard radiologic investigation. MATERIALS AND METHODS Between January 2011 and July 2013, approximately 319 consecutive patients with potentially resectable localized high-risk melanoma or recurrent disease under consideration for metastasectomy underwent PET imaging for staging across 9 institutions in Ontario. Pre-PET stage information was provided by the referring clinician and compared with post-PET stage. The ability of PET to reclassify disease from M0 to M1 status was assessed. The registry data were then linked to provincial administrative databases using deidentified health insurance numbers to determine PET stage-based rates of systemic therapy, radiotherapy, and surgery. RESULTS There was a significant increase in stage to M1 status after PET in 56 of 319 patients (17.6%) (P < 0.0001). There was no significant relationship between upstaging with PET and the proportion of patients receiving radiation therapy (P = 0.066) or systemic therapy (P = 0.072). There was a significant relationship between upstaging with PET and the proportion of patients undergoing surgical resection of metastases distant to the primary melanoma site (P = 0.034). CONCLUSIONS This prospective, multicenter registry of high-risk or advanced melanoma found that PET significantly upstages patients and impacts surgical management.
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Frary EC, Gad D, Bastholt L, Hess S. The role of FDG-PET/CT in preoperative staging of sentinel lymph node biopsy-positive melanoma patients. EJNMMI Res 2016; 6:73. [PMID: 27709489 PMCID: PMC5052236 DOI: 10.1186/s13550-016-0228-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 09/21/2016] [Indexed: 01/23/2023] Open
Abstract
Background On April 1, 2015, Odense University Hospital (OUH) began a new diagnostic strategy, wherein all malignant melanoma (MM) patients in the Region of Southern Denmark with a positive sentinel lymph node biopsy (SLNB) underwent FDG-PET/CT preoperatively prior to lymph node dissection (LND). The purpose of this study is to determine FDG-PET/CT’s efficacy in finding distant metastasis in the first year after the implementation of this new strategy, and to what extent these findings influence subsequent diagnostic testing and treatment in this patient group. We conducted a retrospective multicenter cohort study which included all patients with MM from all hospitals in the Region of Southern Denmark from April 1, 2015 to April 1, 2016 found to be SLNB-positive who subsequently underwent FDG-PET/CT. Patient information was acquired from the Danish Melanoma Database and was cross-referenced with OUH’s patient records. The data was analyzed for a number of parameters including FDG-PET/CT findings and treatment strategy. Median follow-up time was 7 months. Results A total of 47 patients were eligible from the first year of this new diagnostic strategy. One patient was excluded due to undergoing LND prior to FDG-PET/CT. Thus, 46 patients were included in this study. Ultimately, preoperative FDG-PET/CT neither uncovered any distant metastases nor led to any alterations in treatment strategy in this patient group. Conclusions Surprisingly, this new diagnostic strategy did not find any MM metastases or uncover anything else of relevance. FDG-PET/CT did, however, provide false positive findings in 13 % (6/46) of these patients. These scans triggered additional, predominantly invasive, procedures, which did not ultimately have an impact on the therapeutic strategy. Thus, these findings indicate a need for re-evaluation of this new diagnostic strategy as well as the necessity for further clinical trials evaluating FDG-PET/CT’s utility in this clinical setting.
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Affiliation(s)
- Evan C Frary
- Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
| | - Dorte Gad
- Department of Plastic Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Søren Hess
- Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.,Department of Radiology and Nuclear Medicine, Hospital of South West Jutland, Finsengade 10, 6700, Esbjerg, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Wisløvparken 19, 3, 5000, Odense C, Denmark
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Yu X, Li X, Song X, Dai D, Zhu L, Zhu Y, Wang J, Zhao H, Xu W. Advantages and disadvantages of F-18 fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary. Oncol Lett 2016; 12:3785-3792. [PMID: 27895731 PMCID: PMC5104165 DOI: 10.3892/ol.2016.5203] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 09/12/2016] [Indexed: 11/05/2022] Open
Abstract
Carcinoma of unknown primary is a type of malignant disease where the primary carcinoma cannot be identified by conventional examination, which presents challenges in diagnosis and therapy. This study aims to evaluate the detailed clinical value and indications of using fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F-18 FDG PET/CT) in a large sample. A total of 449 patients who were selected under strict standards were retrospectively included in this study. F-18 FDG PET/CT accurately detected the primary carcinoma in 115 of 449 patients whose primaries could not be detected by conventional examination (25.6%), with additional 27 false-positive patients. The most common primary site was the lung (34.8%). In addition, except for in metastatic melanoma (1/19, 5.3%) and axillary metastasis patients (2/49, 4.1%), F-18 FDG PET/CT had a comparative performance in detecting primary carcinoma in other pathological types and anatomical locations. The scan is able to guide treatment strategy modifications to some extent (130/449, 29.0%). We strongly recommend the use of F-18 FDG PET/CT in the early phase of examination. It is also recommended as a supplementary radiological method, and certain patients may benefit from its application in cases where regular examination is inconclusive. However, in metastatic melanoma or axillary metastasis patients where the primary site cannot be identified by routine examination, regular application of F-18 FDG PET/CT for the sole purpose of detecting the primary carcinoma should not be encouraged.
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Affiliation(s)
- Xiaozhou Yu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Xiaofeng Li
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Xiuyu Song
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Dong Dai
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Lei Zhu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Yanjia Zhu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Jian Wang
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Huiqin Zhao
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - Wengui Xu
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China; National Clinical Research Center for Cancer, Tianjin 300060, P.R. China; Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
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Knowles J, Lynch AC, Warrier SK, Henderson M, Heriot AG. A case series of anal melanoma including the results of treatment with imatinib in selected patients. Colorectal Dis 2016; 18:877-82. [PMID: 26546509 DOI: 10.1111/codi.13209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/14/2015] [Indexed: 01/02/2023]
Abstract
AIM Anal melanoma is a rare malignancy with a poor prognosis. METHOD All patients with a diagnosis of anal melanoma treated at a single institution between 2000 and 2012 were identified and their treatment and outcome were evaluated. RESULTS Sixteen patients had a median survival of 2.9 years. Fourteen had Stage I or II disease with a median survival of 4.0 years and progression-free survival of 1.5 years. When used for disease staging, whole body positron emission tomography/CT identified an additional three sites of metastasis in five patients compared with CT of the chest, abdomen and pelvis. Surgery involved wide local excision or abdominoperineal excision with respective local recurrence rates of 50% and 66%. Eleven patients underwent testing for c-Kit mutations, of whom five were positive. Four of these were treated with the tyrosine kinase inhibitor imatinib, and showed rapid response of metastases outside the central nervous system. CONCLUSION The outcome of this malignancy remains poor. PET is the modality of choice for disease staging. Testing tumours for c-Kit mutations may allow selected patients to participate in trials of tyrosine kinase inhibitors.
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Affiliation(s)
- J Knowles
- Department of Colorectal Surgery, Royal Free Hospital, London, UK
| | - A C Lynch
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - S K Warrier
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Henderson
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A G Heriot
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
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Son SH, Kang SM, Jeong SY, Lee SW, Lee SJ, Lee J, Ahn BC. Prognostic Value of Volumetric Parameters Measured by Pretreatment 18F FDG PET/CT in Patients With Cutaneous Malignant Melanoma. Clin Nucl Med 2016; 41:e266-73. [PMID: 27055144 DOI: 10.1097/rlu.0000000000001205] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF THE REPORT This study was performed to evaluate the prognostic relevance of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured using F FDG PET/CT in patients with primary cutaneous malignant melanoma (CMM). MATERIALS AND METHODS We conducted a retrospective review (July 2005 to November 2010) of 41 patients with a histological diagnosis of CMM who underwent pretreatment F FDG PET/CT. PET parameters (maximum standardized uptake value [SUVmax], MTV, and TLG) of the primary tumor were measured. Clinical variables such as age, sex, clinical stage, location and thickness of the primary lesion, and existence of ulceration were also assessed. Univariate and multivariate analyses for disease-free survival (DFS) and melanoma-specific survival (MSS) were performed using the Kaplan-Meier method and Cox proportional hazards models. RESULTS SUVmax and TLG were found to be significantly higher in patients with recurrence than in patients without recurrence (3.98 ± 2.91 vs 1.89 ± 1.35, P = 0.0145; 9.16 ± 8.44 vs 3.72 ± 3.64, P = 0.0249). SUVmax and TLG were also found to be significantly higher in nonsurvivors than in survivors (4.21 ± 3.06 vs 2.00 ± 1.46, P = 0.0260; 10.53 ± 8.83 vs 3.67 ± 3.44, P = 0.0170). The optimal cutoff values for DFS determined using a time-dependent receiver operating characteristic (ROC) curve were 1.8 for SUVmax, 6.07 cm for MTV, and 4.046 for TLG. Sixteen (39%) of the 41 patients experienced recurrence during the follow-up period. In univariate analysis, age (P = 0.0382), male sex (P = 0.0187), ulceration of the primary lesion (P = 0.0001), stage ≥ III (P = 0.0011), SUVmax greater than 1.8 (P = 0.0006), MTV greater than 6.07 cm (P = 0.0136), and TLG greater than 4.046 (P = 0.0010) affected DFS, whereas the other variables (location of the primary lesion and thickness of primary lesion) did not. After adjustment for the effects of the clinical parameters (age, sex, clinical stage, and existence of ulceration), SUVmax, MTV, and TLG were all significant predictors of DFS, and the best predictive factor was SUVmax. Thirteen (32%) of the 41 patients died because of CMM during the follow-up period. The optimal cutoff values for MSS determined using a time-dependent ROC curve were 2.2 for SUVmax, 4.02 cm for MTV, and 4.352 for TLG. In univariate analysis, ulceration of the primary lesion (P = 0.0005), SUVmax greater than 2.2 (P = 0.0001), MTV greater than 4.02 cm (P = 0.0071), and TLG greater than 4.352 (P = 0.0001) affected MSS, whereas the other variables (age, sex, clinical stage, primary lesion site, and thickness of the primary lesion) did not. After adjustment for the effect of the clinical parameter (existence of ulceration), MTV and TLG were significant predictors of MSS, and the best predictive factor of MSS was TLG. CONCLUSIONS Pretreatment MTV and TLG may be useful in stratifying the likelihood of recurrence and melanoma-specific death, and TLG was found to be the best predictive marker for predicting melanoma-specific death.
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Affiliation(s)
- Seung Hyun Son
- From the *Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, Daegu; †Department of Nuclear Medicine, Catholic University of Daegu School of Medicine, Daegu; and ‡Department of Dermatology, Kyungpook National University School of Medicine and Hospital, Daegu, Republic of Korea
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CT imaging of bone and bone marrow infiltration in malignant melanoma—Challenges and limitations for clinical staging in comparison to 18FDG-PET/CT. Eur J Radiol 2016; 85:732-8. [DOI: 10.1016/j.ejrad.2016.01.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/16/2016] [Indexed: 11/19/2022]
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40
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Breslow thickness and 18 F-FDG PET/CT results in initial staging of cutaneous melanoma: Can a cut-off point be established? Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2016.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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41
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Abstract
With the introduction of hybrid imaging technologies such as PET/CT and recently PET/MRI, staging and therapy-response monitoring have evolved. PET/CT has been shown to be of value for routine staging of FDG-avid lymphomas before as well as at the end of treatment. For interim staging, trials are ongoing to evaluate the use of PET/CT. In melanoma, PET/CT can be recommended for stages III and IV diseases for initial staging and before surgery. Studies investigating the use of PET/CT for early therapy response are promising. The role of PET/MR in lymphoma and melanoma imaging has to be defined because no larger studies exist so far. There may be an application of PET/MR in research especially for tumor characterization and therapy response. Furthermore, the potential role of non-FDG tracers is elucidated regarding the assessment of treatment response in targeted drug regimens.
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Affiliation(s)
- Nina F Schwenzer
- Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, Tübingen, Germany.
| | - Anna Christina Pfannenberg
- Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University Tübingen, Tübingen, Germany
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Jayachandran A, Lo PH, Chueh AC, Prithviraj P, Molania R, Davalos-Salas M, Anaka M, Walkiewicz M, Cebon J, Behren A. Transketolase-like 1 ectopic expression is associated with DNA hypomethylation and induces the Warburg effect in melanoma cells. BMC Cancer 2016; 16:134. [PMID: 26907172 PMCID: PMC4763451 DOI: 10.1186/s12885-016-2185-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 02/16/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The metabolism of cancer cells is often reprogrammed by dysregulation of metabolic enzymes. Transketolase-like 1 (TKTL1) is a homodimeric transketolase linking the pentose-phosphate pathway with the glycolytic pathway. It is generally silenced at a transcriptional level in somatic tissues. However, in human cancers its expression is associated with the acquisition of a glycolytic phenotype (the Warburg effect) by cancer cells that contributes to the progression of malignant tumors. In melanoma, defective promoter methylation results in the expression of genes and their products that can affect the tumor cell's phenotype including the modification of immune and functional characteristics. The present study evaluates the role of TKTL1 as a mediator of disease progression in melanoma associated with a defective methylation phenotype. METHODS The expression of TKTL1 in metastatic melanoma tumors and cell lines was analysed by qRT-PCR and immunohistochemistry. The promoter methylation status of TKTL1 in melanoma cells was evaluated by quantitative methylation specific PCR. Using qRT-PCR, the effect of a DNA demethylating agent 5-aza-2'-deoxycytidine (5aza) on the expression of TKTL1 was examined. Biochemical and molecular analyses such as glucose consumption, lactate production, invasion, proliferation and cell cycle progression together with ectopic expression and siRNA mediated knockdown were used to investigate the role of TKTL1 in melanoma cells. RESULTS Expression of TKTL1 was highly restricted in normal adult tissues and was overexpressed in a subset of metastatic melanoma tumors and derived cell lines. The TKTL1 promoter was activated by hypomethylation and treatment with 5aza induced TKTL1 expression in melanoma cells. Augmented expression of TKTL1 in melanoma cells was associated with a glycolytic phenotype. Loss and gain of function studies revealed that TKTL1 contributed to enhanced invasion of melanoma cells. CONCLUSIONS Our data provide evidence for an important role of TKTL1 in aerobic glycolysis and tumor promotion in melanoma that may result from defective promoter methylation. This epigenetic change may enable the natural selection of tumor cells with a metabolic phenotype and thereby provide a potential therapeutic target for a subset of melanoma tumors with elevated TKTL1 expression.
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Affiliation(s)
- Aparna Jayachandran
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia.,School of Cancer Medicine, Latrobe University, Melbourne, VIC, 3086, Australia.,School of Medicine and the Gallipoli Medical Research Foundation, The University of Queensland, Brisbane, QLD 4120, Australia
| | - Pu-Han Lo
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia
| | - Anderly C Chueh
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,ACRF Chemical Biology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, 3052, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Melbourne, 3010, Australia
| | - Prashanth Prithviraj
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Ramyar Molania
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
| | - Mercedes Davalos-Salas
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
| | - Matthew Anaka
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Marzena Walkiewicz
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
| | - Jonathan Cebon
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia.,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia.,Department of Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia.,School of Cancer Medicine, Latrobe University, Melbourne, VIC, 3086, Australia
| | - Andreas Behren
- Ludwig Institute for Cancer Research, Melbourne-Austin Branch, Heidelberg, VIC, 3084, Australia. .,Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia. .,Department of Medicine, University of Melbourne, Melbourne, VIC, 3010, Australia. .,School of Cancer Medicine, Latrobe University, Melbourne, VIC, 3086, Australia. .,Cancer Immuno-biology Laboratory, Olivia Newton-John Cancer Research Institute, Level 5, Olivia Newton-John Cancer and Wellness Centre, 145 Studley Road, Heidelberg, VIC, 3084, Australia.
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Tricoli JV, Blair DG, Anders CK, Bleyer WA, Boardman LA, Khan J, Kummar S, Hayes-Lattin B, Hunger SP, Merchant M, Seibel NL, Thurin M, Willman CL. Biologic and clinical characteristics of adolescent and young adult cancers: Acute lymphoblastic leukemia, colorectal cancer, breast cancer, melanoma, and sarcoma. Cancer 2016; 122:1017-28. [PMID: 26849082 DOI: 10.1002/cncr.29871] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 01/20/2023]
Abstract
Adolescent and young adult (AYA) patients with cancer have not attained the same improvements in overall survival as either younger children or older adults. One possible reason for this disparity may be that the AYA cancers exhibit unique biologic characteristics, resulting in differences in clinical and treatment resistance behaviors. This report from the biologic component of the jointly sponsored National Cancer Institute and LiveStrong Foundation workshop entitled "Next Steps in Adolescent and Young Adult Oncology" summarizes the current status of biologic and translational research progress for 5 AYA cancers; colorectal cancer breast cancer, acute lymphoblastic leukemia, melanoma, and sarcoma. Conclusions from this meeting included the need for basic biologic, genomic, and model development for AYA cancers as well as translational research studies to elucidate any fundamental differences between pediatric, AYA, and adult cancers. The biologic questions for future research are whether there are mutational or signaling pathway differences (for example, between adult and AYA colorectal cancer) that can be clinically exploited to develop novel therapies for treating AYA cancers and to develop companion diagnostics.
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Affiliation(s)
- James V Tricoli
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, Maryland
| | - Donald G Blair
- Division of Cancer Biology, National Cancer Institute, Rockville, Maryland
| | - Carey K Anders
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - W Archie Bleyer
- Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, Oregon
| | - Lisa A Boardman
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Javed Khan
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Shivaani Kummar
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, Maryland
| | - Brandon Hayes-Lattin
- Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, Oregon
| | - Stephen P Hunger
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Melinda Merchant
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Nita L Seibel
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, Maryland
| | - Magdalena Thurin
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, Maryland
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Ortega-Candil A, Rodríguez-Rey C, Cano-Carrizal R, Cala-Zuluaga E, González Larriba JL, Jiménez-Ballvé A, Fuentes-Ferrer ME, Cabrera-Martín MN, Pérez-Castejón MJ, García García-Esquinas M, Lapeña-Gutierrez L, Carreras-Delgado JL. Breslow thickness and (18)F-FDG PET-CT result in initial staging of cutaneous melanoma: Can a cut-off point be established? Rev Esp Med Nucl Imagen Mol 2015; 35:96-101. [PMID: 26597332 DOI: 10.1016/j.remn.2015.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/18/2015] [Accepted: 09/21/2015] [Indexed: 10/22/2022]
Abstract
AIM To establish a Breslow Thickness (BT) cut-off point for indication of PET-CT of cutaneous melanoma in early stages and evaluate its prognostic value. MATERIAL AND METHODS Retrospective analysis of 347 PET-CT studies with diagnosis of melanoma, of which 108 were performed for initial staging. Thirty-one patients were excluded, and a final sample of 77 patients remained. A ROC curve analysis was performed to establish an optimal cut-off point. A survival analysis was performed, considering death assignable to melanoma as the main event, for the evaluation of its prognostic value. RESULTS Forty-seven (61.04%) of all 77 patients selected were men, and 11 (14.29%) had a positive PET-CT result. Mean age was 65.17±15.00 years. The median BT in patients with a negative PET-CT result was 2.75 mm (IQR 1.83-4.50) and in the positive group 6.25 mm (IQR 5.40-7.50) (P=.0013). In the ROC curve analysis (AUC 0.804, SE 0.054), an optimal value of 5 mm BT with the following values was obtained: sensitivity 90.91%, specificity 78.79%, negative predictive value (NPV) 98.1%, positive predictive value (PPV) 41.7%, diagnostic OR 37.1, and accuracy 80.52%. Mean follow-up was 18.66±14,35 months, detecting 2/53 (3.77%) deaths in the BT<5 mm group, and 7/24 (29.17%) in the BT≥5 mm group. Survival curves between both groups were significantly different (P=.0013). CONCLUSIONS A 5 mm cut-off point correctly distinguishes those patients with positive PET-CT from those with negative results in the early stages of cutaneous melanoma; therefore it could be included in initial staging of this subgroup of patients.
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Affiliation(s)
- A Ortega-Candil
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España.
| | - C Rodríguez-Rey
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - R Cano-Carrizal
- Servicio de Cardiología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - E Cala-Zuluaga
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - J L González Larriba
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - A Jiménez-Ballvé
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - M E Fuentes-Ferrer
- Unidad de Gestión Clínica de Medicina Preventiva, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - M N Cabrera-Martín
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - M J Pérez-Castejón
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - M García García-Esquinas
- Servicio de Radiodiagnóstico, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - L Lapeña-Gutierrez
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
| | - J L Carreras-Delgado
- Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, España
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Pfannenberg C, Schwenzer N. [Whole-body staging of malignant melanoma: advantages, limitations and current importance of PET-CT, whole-body MRI and PET-MRI]. Radiologe 2015; 55:120-6. [PMID: 25589421 DOI: 10.1007/s00117-014-2762-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cross-sectional imaging methods are currently the standard methods for staging of advanced melanoma. The former time-consuming and expensive multimodality approach is increasingly being replaced by novel whole-body (WB) staging methods, such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG-PET-CT) and whole-body magnetic resonance imaging (WBMRI) because they offer a complete head-to-toe coverage of the patient in a single examination with an accurate and sensitive detection of tumor spread. Several studies in patients with advanced melanoma revealed that PET-CT is more sensitive and specific than conventional modalities, such as CT alone resulting in a change of management in up to 30 % of cases. Due to the limited sensitivity of PET for lesions smaller than 1 cm, PET-CT is not useful for the initial work-up of patients with stage I and II melanoma but has proven to be superior for detection of distant metastases, which is essential prior to surgical metastasectomy. If PET-CT is not available WB-CT or WB-MRI can alternatively be used and WB-MRI including diffusion-weighted imaging (DWI) has become a real alternative for staging of melanoma patients. So far, however, only few reports suffering from small numbers of cases and heterogeneous design have compared the diagnostic performance of WB-MRI and PET-CT. The preliminary results indicate a high overall diagnostic accuracy of both methods; however, these methods differ in organ-based detection rates: PET-CT was more accurate in N-staging and detection of lung and soft tissue metastases whereas WB-MRI was superior in detecting liver, bone and brain metastases. The value of PET-MRI for staging of advanced melanoma is the subject of ongoing clinical studies.
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Affiliation(s)
- C Pfannenberg
- Abteilung Diagnostische und Interventionelle Radiologie, Eberhard-Karls-Universität Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland,
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Intense FDG uptake in an intra-articular localized giant-cell tumor of the tendon sheath (pigmented villonodular synovitis) mimics metastatic melanoma. Radiol Case Rep 2015; 4:343. [PMID: 27307839 PMCID: PMC4898176 DOI: 10.2484/rcr.v4i4.343] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
We describe a patient with metastatic melanoma, one year following a clinical trial of VEGF
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Petersen H, Holdgaard PC, Madsen PH, Knudsen LM, Gad D, Gravergaard AE, Rohde M, Godballe C, Engelmann BE, Bech K, Teilmann-Jørgensen D, Mogensen O, Karstoft J, Johansen J, Christensen JB, Johansen A, Høilund-Carlsen PF. FDG PET/CT in cancer: comparison of actual use with literature-based recommendations. Eur J Nucl Med Mol Imaging 2015; 43:695-706. [PMID: 26519292 PMCID: PMC4764641 DOI: 10.1007/s00259-015-3217-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/06/2015] [Indexed: 12/22/2022]
Abstract
Purpose The Region of Southern Denmark (RSD), covering 1.2 of Denmark’s 5.6 million inhabitants, established a task force to (1) retrieve literature evidence for the clinical use of positron emission tomography (PET)/CT and provide consequent recommendations and further to (2) compare the actual use of PET/CT in the RSD with these recommendations. This article summarizes the results. Methods A Work Group appointed a professional Subgroup which made Clinician Groups conduct literature reviews on six selected cancers responsible for 5,768 (62.6 %) of 9,213 PET/CT scans in the RSD in 2012. Rapid Evidence Assessment was applied, using the methodology of systematic reviews with predefined limitations to search PubMed, Embase and the Cochrane Library for articles published in English/Danish/Swedish/Norwegian since 2002. PICO questions were defined, data recorded and quality appraised and rated with regard to strength and evidence level. Consequent recommendations for applications of PET/CT were established. The actual use of PET/CT was compared with these, where grades A and B indicated “established” and “useful” and grades C and D “potentially useful” and “non-recommendable” indications, respectively. Results Of 11,729 citations, 1,729 were considered for review, and 204 were included. The evidence suggested usefulness of PET/CT in lung, lymphoma, melanoma, head and neck, and colorectal cancers, whereas evidence was sparse in gynaecological cancers. The agreement between actual use of PET/CT and literature-based recommendations was high in the first five mentioned cancers in that 96.2 % of scans were made for grade A or B indications versus only 22.2 % in gynaecological cancers. Conclusion Evidence-based usefulness was reported in five of six selected cancers; evidence was sparse in the sixth, gynaecological cancers. Actual use of PET/CT agreed well with recommendations. Electronic supplementary material The online version of this article (doi:10.1007/s00259-015-3217-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Henrik Petersen
- Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | | | | | | | - Dorte Gad
- Department of Plastic Surgery, Odense University Hospital, Odense, Denmark
| | | | - Max Rohde
- Department of ORL Head & Neck Surgery, Odense University Hospital, Odense, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck Surgery, Odense University Hospital, Odense, Denmark
| | | | - Karsten Bech
- Organ Centre, Aabenraa Sygehus, Aabenraa, Denmark
| | | | - Ole Mogensen
- Department of Gynaecoligcal and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Jens Karstoft
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Jørgen Johansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | | | - Allan Johansen
- Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
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(18)F-FDG PET/CT and Melanoma: Staging, Immune Modulation and Mutation-Targeted Therapy Assessment, and Prognosis. AJR Am J Roentgenol 2015. [PMID: 26204273 DOI: 10.2214/ajr.14.13575] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Monoclonal antibodies that target the programmed cell death 1 (PD-1) immune checkpoint protein and its associated ligands, PD-L1 and PD-L2, and targeted inhibitors of mutated signal transduction molecules such as BRAF inhibitors show immense promise in treating patients with melanoma. We discuss the use of (18)F-FDG PET/CT for assessing therapy effectiveness, staging advanced disease, and determining prognosis of patients with melanoma. CONCLUSION FDG PET/CT is useful in staging disease, assessing therapy, and determining prognosis in patients with melanoma.
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Dohan A, Faraoun S, Barral M, Guerrache Y, Boudiaf M, Dray X, Hoeffel C, Allez M, Farges O, Beaugerie L, Aparicio T, Marteau P, Fishman E, Lucidarme O, Eveno C, Pocard M, Dautry R, Soyer P. Extra-intestinal malignancies in inflammatory bowel diseases: An update with emphasis on MDCT and MR imaging features. Diagn Interv Imaging 2015; 96:871-83. [DOI: 10.1016/j.diii.2015.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 02/24/2015] [Indexed: 12/11/2022]
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Feng H, Xia X, Li C, Song Y, Qin C, Liu Q, Zhang Y, Lan X. Imaging malignant melanoma with (18)F-5-FPN. Eur J Nucl Med Mol Imaging 2015; 43:113-122. [PMID: 26260649 DOI: 10.1007/s00259-015-3134-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/07/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE Radiolabelled benzamides are attractive candidates for targeting melanoma because they bind to melanin and exhibit high tumour uptake and retention. (18)F-5-Fluoro-N-(2-[diethylamino]ethyl)picolinamide ((18)F-5-FPN), a benzamide analogue, was prepared and its pharmacokinetics and binding affinity evaluated both in vitro and in vivo to assess its clinical potential in the diagnosis and staging of melanoma. METHODS (18)F-5-FPN was prepared and purified. Its binding specificity was measured in vitro in two different melanoma cell lines, one pigmented (B16F10 cells) and one nonpigmented (A375m cells), and in vivo in mice xenografted with the same cell lines. Dynamic and static PET images using (18)F-5-FPN were obtained in the tumour-bearing mice, and the static images were also compared with those acquired with (18)F-FDG. PET imaging with (18)F-5-FPN was also performed in B16F10 tumour-bearing mice with lung metastases. RESULTS (18)F-5-FPN was successfully prepared with radiochemical yields of 5 - 10 %. Binding of (18)F-5-FPN to B16F10 cells was much higher than to A375m cells. On dynamic PET imaging B16F10 tumours were visible about 1 min after injection of the tracer, and the uptake gradually increased over time. (18)F-5-FPN was rapidly excreted via the kidneys. B16F10 tumours were clearly visible on static images acquired 1 and 2 h after injection, with high uptake values of 24.34 ± 6.32 %ID/g and 16.63 ± 5.41 %ID/g, respectively, in the biodistribution study (five mice). However, there was no visible uptake by A375m tumours. (18)F-5-FPN and (18)F-FDG PET imaging were compared in B16F10 tumour xenografts, and the tumour-to-background ratio of (18)F-5-FPN was ten times higher than that of (18)F-FDG (35.22 ± 7.02 vs. 3.29 ± 0.53, five mice). (18)F-5-FPN PET imaging also detected simulated lung metastases measuring 1 - 2 mm. CONCLUSION (18)F-5-FPN specifically targeted melanin in vitro and in vivo with high retention and affinity and favourable pharmacokinetics. (18)F-5-FPN may be an ideal molecular probe for melanoma diagnosis and staging.
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Affiliation(s)
- Hongyan Feng
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Xiaotian Xia
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Chongjiao Li
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Yiling Song
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Chunxia Qin
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Qingyao Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Yongxue Zhang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Key Laboratory of Molecular Imaging, No. 1277 Jiefang Ave, Wuhan, 430022, China.
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