Advertisement

Molecular Imaging and Biology

, Volume 8, Issue 4, pp 212–217 | Cite as

Merkel Cell Carcinoma: Is there a Role for 2-Deoxy-2-[F-18]fluoro-d-glucose-Positron Emission Tomography/Computed Tomography?

  • A. Iagaru
  • A. Quon
  • I. R. McDougall
  • S. S. GambhirEmail author
Brief Article

Abstract

Purpose

2-Deoxy-2-[F-18]fluoro-d-glucose (FDG)–positron emission tomography (PET)/computed tomography (CT) is becoming widely available as a powerful imaging modality, combining the ability to detect active metabolic processes and their morphologic features in a single study. The role of FDG-PET/CT is proven in lymphoma, melanoma, colorectal carcinoma, and other cancers. However, there are rare malignancies such as Merkel cell carcinoma that can potentially be evaluated with PET/CT. We were therefore prompted to review our experience with FDG-PET/CT in the management of patients with Merkel cell carcinoma.

Procedures

This is a retrospective case series of six patients with Merkel cell carcinoma, 58–81 years old (average 69 ± 8.3), who had whole-body PET/CT at our institution from January 1st, 2003 to August 31st, 2005. Two patients were women and four were men. Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed.

Results

Twelve examinations were acquired for the six patients (one patient had six PET/CT, one patient had two PET/CT, and four patients had one PET/CT). The injected FDG doses ranged 381.1–669.7 MBq (average 573.5 ± 70.3). Four patients had the PET/CT as part of initial staging, and two patients had the exam for restaging (after surgery and XRT). A total of six Merkel lesions (pancreas, adrenal, lip, submandibular lymph nodes, cervical lymph nodes, and parapharyngeal soft tissue) were identified in three patients and confirmed on histopathological examination. The FDG uptake in these areas was intense, with maximum standardized uptake value (SUVmax) values of 5–14 (average 10.4 ± 3.8). In one patient, the PET/CT scan identified abnormal focal distal sigmoid uptake that was biopsied and diagnosed as adenocarcinoma. Two patients had negative scans and had no clinical evidence of disease on follow-up office visits (up to one year after PET/CT).

Conclusions

This case series suggests that FDG-PET/CT may have a promising role in the management of patients with Merkel cell carcinoma.

Key words

Merkel cell Carcinoma FDG PET/CT 

References

  1. 1.
    Nghiem P, McKee PH, Haynes HA (2001) Merkel cell (cutaneous neuroendocrine) carcinoma. In: Sober AJ, Haluska FG (eds) Skin cancer. Hamilton, Ontario: BC Decker Inc., pp 127–141Google Scholar
  2. 2.
    Toker C (1972, January) Trabecular carcinoma of the skin. Arch Dermatol 105(1):107–110, JanuaryCrossRefPubMedGoogle Scholar
  3. 3.
    Sidhu GS, Chandra P, Cassai ND (2005, May–August) Merkel cells, normal and neoplastic: an update. Ultrastruct Pathol 29(3–4):287–294CrossRefPubMedGoogle Scholar
  4. 4.
    Allen PJ, Bowne WB, Jaques DP, Brennan MF, Busam K, Coit DG (2005, April 1) Merkel cell carcinoma: prognosis and treatment of patients from a single institution. J Clin Oncol 23(10):2300–2309CrossRefPubMedGoogle Scholar
  5. 5.
    Gambhir SS (2002, September) Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer 2(9):683–693CrossRefPubMedGoogle Scholar
  6. 6.
    Sugawara Y, Zasadny KR, Neuhoff AW, Wahl RL (1999, November) Reevaluation of the standardized uptake value for FDG: variations with body weight and methods for correction. Radiology 213(2):521–525PubMedGoogle Scholar
  7. 7.
    Wasserberg N, Schachter J, Fenig E, Feinmesser M, Gutman H (2000, February) Applicability of the sentinel node technique to Merkel cell carcinoma. Dermatol Surg 26(2):138–141CrossRefPubMedGoogle Scholar
  8. 8.
    Durani BK, Klein A, Henze M, Haberkorn U, Hartschuh W (2003, June) Somatostatin analogue scintigraphy in Merkel cell tumours. Br J Dermatol 148(6):1135–1140CrossRefPubMedGoogle Scholar
  9. 9.
    Castagnoli A, Biti G, De Cristofaro MT, et al. (1992) Merkel cell carcinoma and iodine-131 metaiodobenzylguanidine scan. Eur J Nucl Med 19(10):913–916CrossRefPubMedGoogle Scholar
  10. 10.
    Watanabe N, Shimizu M, Kageyama M, Kitagawa K, Hayasaka S, Seto H (1998, August) 123I-MIBG SPECT of Merkel cell carcinoma. Br J Radiol 71(848):886–887PubMedGoogle Scholar
  11. 11.
    Von Moll L, McEwan AJ, Shapiro B, et al. (1987, June) Iodine-131 MIBG scintigraphy of neuroendocrine tumors other than pheochromocytoma and neuroblastoma. J Nucl Med 28(6):979–988PubMedGoogle Scholar
  12. 12.
    Lampreave JL, Benard F, Alavi A, Jimenez-Hoyuela J, Fraker D (1998, December) PET evaluation of therapeutic limb perfusion in Merkel's cell carcinoma. J Nucl Med 39(12):2087–2090PubMedGoogle Scholar
  13. 13.
    Wong CO, Pham AN, Dworkin HJ (2000, March) F-18 FDG Accumulation in an Octreotide negative Merkel cell tumor. Clin Positron Imaging 3(2):71–73CrossRefPubMedGoogle Scholar
  14. 14.
    Nguyen BD (2002, December) Positron emission tomographic imaging of Merkel cell carcinoma. Clin Nucl Med 27(12):922–923CrossRefPubMedGoogle Scholar
  15. 15.
    Lin O, Thomas A, Singh A, Greenspan B (2004, November) Complementary role of positron emission tomography in Merkel cell carcinoma. South Med J 97(11):1110–1112CrossRefPubMedGoogle Scholar
  16. 16.
    Yao M, Smith RB, Hoffman HT, Funk GF, Graham MM, Buatti JM (2005, April) Merkel cell carcinoma: two case reports focusing on the role of fluorodeoxyglucose positron emission tomography imaging in staging and surveillance. Am J Clin Oncol 28(2):205–210CrossRefPubMedGoogle Scholar
  17. 17.
    Scanga DR, Martin WH, Delbeke D (2004, February) Value of FDG PET imaging in the management of patients with thyroid, neuroendocrine, and neural crest tumors. Clin Nucl Med 29(2):86–90CrossRefPubMedGoogle Scholar
  18. 18.
    Talbot JN, Kerrou K, Missoum F, et al. (2005, August 5) 6-[F-18]Fluoro-L: -DOPA positron emission tomography in the imaging of Merkel cell carcinoma: preliminary report of three cases with 2-deoxy-2-[F-18]Fluoro-d: -glucose positron emission tomography or pentetreotide-(111In) SPECT Data. Mol Imaging Biol 1–5Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2006

Authors and Affiliations

  • A. Iagaru
    • 1
  • A. Quon
    • 1
  • I. R. McDougall
    • 1
  • S. S. Gambhir
    • 2
    Email author
  1. 1.Division of Nuclear Medicine, Department of RadiologyStanford University Medical CenterStanfordUSA
  2. 2.Division of Nuclear Medicine, Departments of Radiology and Bioengineering, Molecular Imaging Program at Stanford (MIPS)Stanford University School of MedicineStanfordUSA

Personalised recommendations