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Recurrence of Melanoma After Initial Treatment: Diagnostic Performance of FDG PET in Posttreatment Surveillance

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Abstract

Purpose

In malignant melanoma, recurrence is often observed in distant areas from the primary site. While FDG PET is a sensitive imaging for detecting malignant lesions, the role of FDG PET in posttreatment surveillance period has not been investigated sufficiently. The aim of this study was to evaluate the value of PET during posttreatment surveillance in melanoma.

Methods

A total of 76 melanoma patients who underwent FDG PET during surveillance period after completion of the first treatment were retrospectively enrolled. PET scans were grouped according to the purpose and clinical situations, routine surveillance, or evaluating clinical suspicion. Final diagnosis of recurrence was determined by complete clinical evaluation or long-term follow-up. In each situation, the diagnostic role of FDG PET was assessed.

Results

A total of 143 scans of 76 patients were analyzed: 51 for clinical suspicion and 92 for routine surveillance. In the clinical suspicion group, PET correctly diagnosed non-recurrence in 10 cases (20%). In routine surveillance group, 16 cases (17%) presented recurrence, all of which was correctly diagnosed on PET. NPV and PPV were 100% and 76%, respectively. In subgroup analysis, sensitivity and NPV were higher in the low-risk group (stages I–IIA) than in the high-risk group (stages IIB–IV), while specificity and PPV were higher in the high-risk group.

Conclusion

In conclusion, FDG PET is an effective diagnostic tool in posttreatment surveillance of melanoma. Even in cases without clinical suspicion, melanoma recurs in a considerable proportion of patients, which can be sensitively diagnosed on PET.

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References

  1. Nikolaou V, Stratigos AJ. Emerging trends in the epidemiology of melanoma. Br J Dermatol. 2014;170:11–9.

    Article  CAS  PubMed  Google Scholar 

  2. Chen L, Jin S. Trends in mortality rates of cutaneous melanoma in East Asian populations. PeerJ. 2016;4:e2809.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Faries MB, Steen S, Ye X, Sim M. Late recurrence in melanoma: clinical implications of lost dormancy. J Am Coll Surg. 2013;217:27–34.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Romano E, Scordo M, Dusza SW, Coit DG, Chapman PB. Site and timing of first relapse in stage III melanoma patients: implications for follow-up guidelines. J Clin Oncol. 2010;28:3042–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Meyers MO, Yeh JJ, Frank J, Long P, Deal AM, Amos KD, et al. Method of detection of initial recurrence of stage II/III cutaneous melanoma: analysis of the utility of follow-up staging. Ann Surg Oncol. 2009;16:941–7.

    Article  PubMed  Google Scholar 

  6. Bichakjian CK, Halpern AC, Johnson TM, Hood AF, Grichnik JM, Swetter SM, et al. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol. 2011;65:1032–47.

    Article  PubMed  Google Scholar 

  7. Trotter SC, Sroa N, Winkelmann RR, Olencki T, Bechtel M. A global review of melanoma follow-up guidelines. J Clin Aesthet Dermatol. 2013;6:18–26.

    PubMed  PubMed Central  Google Scholar 

  8. Reinhardt MJ, Joe AY, Jaeger U, Huber A, Matthies A, Bucerius J, et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol. 2006;24:1178–87.

    Article  PubMed  Google Scholar 

  9. Beasley GM, Parsons C, Broadwater G, Selim MA, Marzban S, Abernethy AP, et al. A multicenter prospective evaluation of the clinical utility of F-18 FDG-PET/CT in patients with AJCC stage IIIB or IIIC extremity melanoma. Ann Surg. 2012;256:350–6.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Brown RE, Stromberg AJ, Hagendoorn LJ, Hulsewede DY, Ross MI, Noyes RD, et al. Surveillance after surgical treatment of melanoma: futility of routine chest radiography. Surgery. 2010;148:711–7.

    Article  PubMed  Google Scholar 

  11. Danielsen M, Hojgaard L, Kjaer A, Fischer BMB, et al. Positron emission tomography in the follow-up of cutaneous malignant melanoma patients: a systematic review. Am J Nucl Med Mol Imaging. 2014;4:17–28.

    Google Scholar 

  12. Hengge UR, Wallerand A, Stutzki A, Kochel N. Cost-effectiveness of reduced follow-up in malignant melanoma. J Dtsch Dermatol Ges. 2007;5:898–907.

    Article  PubMed  Google Scholar 

  13. Koskivuo IO, Seppanen MP, Suominen EA, Minn HR. Whole body positron emission tomography in follow-up of high risk melanoma. Acta Oncol. 2007;46:685–90.

    Article  PubMed  Google Scholar 

  14. Morton RL, Craig JC, Thompson JF. The role of surveillance chest X-rays in the follow-up of high-risk melanoma patients. Ann Surg Oncol. 2009;16:571–7.

    Article  PubMed  Google Scholar 

  15. Taghipour M, Marcus C, Sheikhbahaei S, Mena E, Prasad S, Jha AK, et al. Clinical indications and impact on management: fourth and subsequent posttherapy follow-up 18F-FDG PET/CT scans in oncology patients. J Nucl Med. 2017;58:737–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Choi EK, Yoo IR, Park HL, Choi HS, Han EJ, Kim SH, et al. Value of surveillance 18F-FDG PET/CT in colorectal cancer: comparison with conventional imaging studies. Nucl Med Mol Imaging. 2012;46:189–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Lewin J, Sayers L, Kee D, Walpole I, Sanelli A, Marvelde LT, et al. Surveillance imaging with FDG-PET/CT in the post-operative follow-up of stage 3 melanoma. Ann Oncol. 2018; https://doi.org/10.1093/annonc/mdy124.

  18. National Comprehensive Cancer Network (NCCN). NCCN guidelines version 2. 2018 Melanoma. https://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf. Accessed April 11, 2018.

  19. Vensby PH, Schmidt G, Kjær A, Fischer BM. The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis. Am J Nucl Med Mol Imaging. 2017;7:255–62.

    PubMed  PubMed Central  Google Scholar 

  20. Mena E, Taghipour M, Sheikhbahaei S, Mipour S, Xiao J, Shbramaniam RM. 18F-FDG PET/CT and melanoma: value of fourth and subsequent posttherapy follow-up scans for patient management. Clin Nucl Med. 2016;41:e403–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Hwan Hee Lee, Jin Chul Paeng, Gi Jeong Cheon, Dong Soo Lee, June-Key Chung & Keon Wook Kang

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  1. Hwan Hee Lee
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  2. Jin Chul Paeng
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  3. Gi Jeong Cheon
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  4. Dong Soo Lee
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Correspondence to Jin Chul Paeng.

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Conflict of Interest

Hwan Hee Lee, Jin Chul Paeng, Gi Jeong Cheon, Dong Soo Lee, June-Key Chung, and Keon Wook Kang declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The study design of the retrospective analysis and exemption of informed consent were approved by the Institutional Review Board of the Seoul National University Hospital (H-1804-008-932).

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Lee, H.H., Paeng, J.C., Cheon, G.J. et al. Recurrence of Melanoma After Initial Treatment: Diagnostic Performance of FDG PET in Posttreatment Surveillance. Nucl Med Mol Imaging 52, 327–333 (2018). https://doi.org/10.1007/s13139-018-0537-6

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  • DOI: https://doi.org/10.1007/s13139-018-0537-6

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