Abstract
Purpose: :
To report our experience with whole body Positron Emission Tomography/Computed Tomography (PET/CT) screening for metastatic uveal melanoma.
Methods: :
333 consecutive patients were diagnosed with uveal melanoma and underwent screening for metastatic disease with PET/CT and liver function tests. PET/CT results suspicious for metastatic melanoma prompted further biopsies, blood tests, imaging and/or clinical evaluations for confirmation.
Results: :
Seven of 333 (2.1%) patients were found to have metastatic choroidal melanoma. Ten (3.3%) were diagnosed with synchronous second cancers and 28 (8.4%) had benign lesions. The most common metastatic sites were liver (n=7), osseous (n=2), lungs, brain, spleen, lymph nodes and subcutaneous tissue (each n=1). Liver function tests were within normal limits in all metastatic patients. Using AJCC-UICC tumor staging criteria, one of the primary tumors was classified as T3, and 6 were T4. By COMS criteria, there was 1 medium and 6 large melanomas. PET/CT significantly improved the yield of metastases detection in T4 tumors in comparison to previous reports.
Conclusions: :
Our findings support the use of PET/CT as a screening procedure for metastatic disease in uveal melanoma patients, especially in patients with large tumors that present an increased risk for patent metastatic disease at time of diagnosis.
Keywords: tumors • melanoma • imaging/image analysis: clinical