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Metabolic activity of primary uveal melanoma on PET/CT scan and its relationship with monosomy 3 and other prognostic factors
  1. Vasilios P Papastefanou1,
  2. Shahriar Islam2,
  3. Teresa Szyszko2,
  4. Marianne Grantham3,
  5. Mandeep S Sagoo1,4,
  6. Victoria M L Cohen1
  1. 1Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK
  2. 2Department of Nuclear Medicine, St Bartholomew`s Hospital, London, UK
  3. 3Department of Molecular Medicine, Royal London Hospital, London, UK
  4. 4UCL Institute of Ophthalmology, London, UK
  1. Correspondence to Victoria M L Cohen, Ocular Oncology Service, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK; victoria.cohen{at}bartshealth.nhs.uk

Abstract

Purpose To correlate the metabolic activity of primary uveal melanoma on positron emission tomography (PET)/CT scan with known clinical and pathological prognostic factors.

Methods A retrospective cohort analysis of eyes enucleated for uveal melanoma that underwent preoperative imaging with a PET/CT scan was performed. Tumour dimensions were recorded and classified using Collaborative Ocular Melanoma Study (COMS) and American Joint Committee on Cancer (AJCC) Tumour - Nodes - Metastases (TNM) criteria. Metabolic activity was determined by measurement of the maximal standardised uptake value (SUVmax) on PET/CT scans. SUVmax of >2.5 and >4 was also used as cut-off value for metabolic positivity. Chromosome 3 and 8 status was determined using fluorescence in situ hybridisation analysis. Pearson correlation, χ2 test and non-parametric tests were used. p<0.05 was considered statistically significant.

Results Seventy-six uveal melanomas were imaged preoperatively with a PET/CT scan. Overall 92% of tumours had a SUVmax >2.5 and 67% had a SUVmax >4. Monosomy 3 was found in 35 melanomas, of which 94% had an SUVmax >2.5 and 80% had an SUVmax >4. Only 57% of disomy 3 melanomas had an SUVmax >4. SUVmax was significantly increased in tumours with monosomy 3 (p=0.043) but not in tumours with chromosome 8 gain (p=0.49). SUVmax and increasing tumour size were positively correlated (p<0.05). Using the AJCC criteria, there was a significant difference in SUVmax among prognostic groups (p=0.024). There was no correlation with histopathological cell type (p=0.923).

Conclusions Metabolic activity of uveal melanoma on PET/CT scan is positively correlated with monosomy 3, increasing tumour size and TNM prognostic groups. No association with chromosome 8 gain or histopathology cell type was noted. SUVmax >4 is a relative but not an absolute indicator of monosomy 3 status.

  • choroid
  • neoplasia
  • pathology
  • imaging
  • genetics

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