부산대학교 도서관

Simple Summary: Malignant melanoma is an aggressive malignancy with an unproportionally high mortality rate among skin-related malignancies, being the third most common cancer that metastasizes to the brain. Approximately 10% of patients with a history of invasive melanoma ultimately develop brain metastases. In metastatic patients, this presentation rate increases up to 60%. 18F-FDG PET/CT is an accurate imaging modality for detecting melanoma metastases. However, the well-known limitation of 18F-FDG PET/CT is its unfavourable tumour-to-background uptake ratio in the brain. Thus, as the mainstay assessment tool for distant metastasis, the prognostic value of 18F-FDG PET/CT-derived parameters is important to determine, especially considering the brain. However, regarding prognostication, the majority of previous studies have included small populations of advanced-stage melanoma patients. Also, data regarding the baseline prognostic value of 18F-FDG PET/CT in melanoma patients with brain metastases are scarce. Thus, we aimed to investigate its prognostic value in predicting the occurrence of brain metastases in melanoma patients. To investigate the value of 18F-FDG-PET/CT in predicting the occurrence of brain metastases in melanoma patients, in this retrospective study 201 consecutive patients with pathology-proven melanoma, between 2008 and 2021, were reviewed. Those who underwent 18F-FDG-PET/CT for initial staging were considered eligible. Baseline assessment included histopathology, 18F-FDG-PET/CT, and brain MRI. Also, all patients had serial follow-ups for diagnosing brain metastasis development. Baseline 18F-FDG-PET/CT parameters were analysed using competing risk regression models to analyze their correlation with the occurrence of brain metastases. Overall, 159 patients entered the study. The median follow-up was six years. Among clinical variables, the initial M-stage and TNM-stage were significantly correlated with brain metastasis. Regarding 18F-FDG-PET/CT parameters, regional metastatic lymph node uptake values, as well as prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), were significantly correlated with the outcome. Cumulative incidences were 10% (6.3–16%), 31% (24.4–38.9%), and 35.2% (28.5–43.5%) after 1, 5, and 10 years. There were significant correlations between pSULmax (p-value < 0.001) and pSULpeak (p-value < 0.001) and the occurrence of brain metastases. The higher these values, the sooner the patient developed brain metastases. Thus, baseline 18F-FDG-PET/CT may have the potential to predict brain metastasis in melanoma patients. Those with high total metabolic activity should undergo follow-up/complementary evaluations, such as brain MRI. [ABSTRACT FROM AUTHOR]