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Chemotherapy response assessment in stage IV melanoma patients—comparison of 18F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

This study aims to compare the use of 18F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B in chemotherapy response assessment of stage IV melanoma patients.

Methods

In 25 patients with stage IV melanoma, FDG-PET/CT and S-100B after 2–3 months (three cycles) of chemotherapy was compared with baseline PET/CT and baseline S-100B. Retrospectively, the response was correlated with the outcome. In patients with clinical suspicion for brain metastases, MRI or CCT was performed.

Results

There was agreement between FDG-PET/CT and CT regarding response to chemotherapy in all patients. There was a clear trend to a longer OS of PET/CT responders (n = 10) compared with PET/CT non-responders (n = 15; p = 0.072) with remarkably better 1-year OS of 80% compared to 40% (p = 0.048). There was a significant longer PFS of PET/CT responders compared with PET/CT non-responders (p = 0.002). S-100B was normal at baseline in eight of 22 patients where it was available. Chemotherapy response assessment with S-100B failed to show correlation with OS or PFS. Eleven patients developed brain metastases during treatment, first detected by PET/CT in two and by MRI or CCT in nine of 11 patients. Appearance of brain metastases was associated with a poor survival.

Conclusions

18F-FDG-PET/CT and CT alone are equally suitable for chemotherapy response assessment in melanoma patients and clearly superior to S-100B. PET/CT responders have better early survival, but this is shortlived due to late therapy failure—often with brain recurrence. Additional brain MRI for therapy response assessment in such high-risk patients is mandatory to detect brain metastases missed by PET/CT.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland

    Klaus Strobel, Hans C. Steinert, Marisol Pérez Lago, Jan D. Soyka, P. Veit-Haibach & V. Kalff

  2. Department of Dermatology, University Hospital Zurich, Zurich, Switzerland

    Reinhard Dummer, Katrin Baumann Conzett & Karin Schad

  3. Biostatistics Unit, University of Zurich, Zurich, Switzerland

    Burkhardt Seifert

  4. Department of Nuclear Medicine, Alfred Hospital Melbourne, Melbourne, Australia

    V. Kalff

Authors
  1. Klaus Strobel
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  2. Reinhard Dummer
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  3. Hans C. Steinert
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  4. Katrin Baumann Conzett
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  6. Marisol Pérez Lago
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  7. Jan D. Soyka
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  9. Burkhardt Seifert
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  10. V. Kalff
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Correspondence to Klaus Strobel.

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Strobel, K., Dummer, R., Steinert, H.C. et al. Chemotherapy response assessment in stage IV melanoma patients—comparison of 18F-FDG-PET/CT, CT, brain MRI, and tumormarker S-100B. Eur J Nucl Med Mol Imaging 35, 1786–1795 (2008). https://doi.org/10.1007/s00259-008-0806-1

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  • DOI: https://doi.org/10.1007/s00259-008-0806-1

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