Article Text
Abstract
Aim: To investigate the value of whole body positron emission tomography/computed tomography (PET/CT) in screening for metastatic choroidal melanoma in patients initially diagnosed with choroidal melanoma.
Methods: 52 patients with choroidal melanoma underwent whole body PET/CT as part of their metastatic investigation. PET/CT scans were used as a screening tool at the time of their initial diagnosis. A physical examination, liver function tests, and a baseline chest x ray were also obtained. PET/CT images (utilising intravenous18-fluoro-2-deoxyglucose (FDG)) were studied for the presence of metastatic melanoma. The standards for reference were further imaging and/or subsequent biopsies.
Results: Two of 52 (3.8%) patients were found to have metastatic melanoma before treatment. The most common sites for metastases were the liver (100%), bone (50%), and lymph nodes (50%). Brain involvement was also present in one patient. One patient (50%) had involvement of multiple sites. Haematological liver enzyme assays were normal in both patients. PET/CT showed false positive results in three patients (5.7%) when further evaluated by histopathology and/or additional imaging. In seven patients (13.4%) PET/CT imaging detected benign lesions in the bone, lung, lymph nodes, colon, and rectum.
Conclusion: PET/CT imaging can be used as a screening tool for the detection and localisation of metastatic choroidal melanoma. Liver enzyme assays did not identify liver metastases, while PET/CT revealed both hepatic and extrahepatic metastatic melanoma. PET/CT imaging may improve upon the conventional methods of screening for detection of metastatic disease in patients initially diagnosed with choroidal melanoma.
- AJCC, American Joint Cancer Committee Classification
- BGO, bismuth germanate
- COMS, Collaborative Ocular Melanoma Study
- CT, computed tomography
- FDG, 18-fluoro-2-deoxyglucose
- MRI, magnetic resonance imaging
- PET, positron emission tomography
- SUV, standardised uptake values
- PET/CT
- melanoma
- metastasis
- imaging
- AJCC, American Joint Cancer Committee Classification
- BGO, bismuth germanate
- COMS, Collaborative Ocular Melanoma Study
- CT, computed tomography
- FDG, 18-fluoro-2-deoxyglucose
- MRI, magnetic resonance imaging
- PET, positron emission tomography
- SUV, standardised uptake values
- PET/CT
- melanoma
- metastasis
- imaging
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Footnotes
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Supported by The EyeCare Foundation, Inc, and Research to Prevent Blindness, New York City, New York, NY, USA
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Competing interests: none declared