Nuklearmedizin 2013; 52(05): 198-203
DOI: 10.3413/Nukmed-0584-13-05
Original article
Schattauer GmbH

18FDG-PET to assess recurrence and long term survival in patients with malignant melanoma

Nutzen der 18F-FDG-PET im Nachweis eines Rezidives und des Langzeitüberlebens bei Patienten mit malignem Melanom
H. A. Wieder
1   Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Germany
2   Department of Nuclear Medicine, University Hospital Essen, Germany
,
G. Tekin
3   Department of Dermatology, University Hospital Essen, Germany
,
S. Rosenbaum-Krumme
3   Department of Dermatology, University Hospital Essen, Germany
,
J. Klode
4   Department of Diagnostic and Interventional Radiology and Neuro radiology, University Hospital Essen, Germany
,
J. Altenbernd
4   Department of Diagnostic and Interventional Radiology and Neuro radiology, University Hospital Essen, Germany
,
A. Bockisch
3   Department of Dermatology, University Hospital Essen, Germany
,
J. Nagarajah
3   Department of Dermatology, University Hospital Essen, Germany
› Author Affiliations
Further Information

Publication History

received: 07 May 2013

accepted in revised form: 14 July 2013

Publication Date:
12 January 2018 (online)

Summary

Aim: To assess the diagnostic and prognostic value of FDG-PET/CT in the follow-up of malignant melanoma in comparison to the serum protein S100B. Patients and methods: A total of ninety patients with either low-risk or high-risk malignant melanoma, respectively, were included in this study. The followup of the patients was pursuant with the guidelines of the German Dermatological Association. The diagnostic accuracy and diagnostic power were determined for PET/CT and for the serum protein S100B. Results: In 28 of the 90 patients PET/CT was positive in the follow up, 47 patients had an elevated Serum S100B level. Sensitivity, specificity, PPV and NPV of PET/CT for the total groups of patients were 87%, 93%, 87% and 93%. The corresponding values for the serum protein S100B were 65%, 52%, 43% and 74%, respectively. PET/CT positive patients showed a significantly (p < 0.001) higher risk of melanoma associated death compared to patients with PET/CT negative findings. No statistical significance could be found in the 5 year survival rate between the S100B positive and S100B negative patients. Conclusion: PET/CT is suitable to confirm or exclude recurrences and can be used to assess the prognosis in melanoma patients. The diagnostic accuracy and the prognostic power is much higher compared to the serum protein S100B.

Zusammenfassung

Ziel: Die diagnostische und prognostische Genauigkeit der PET/CT in der Nachsorge des malignen Melanoms zu überprüfen. Patienten, Methoden: Insgesamt wurden 95 Patienten mit low-risk oder high-risk malignem Melanom in die Studie eingeschlossen. Die Nachsorge erfolgte nach den Leitlinien der Deutschen Dermatologischen Gesellschaft. Die diagnostische Genauigkeit wurde für die PET/ CT und das Serumprotein S100B bestimmt. Ergebnisse: In der Nachsorge hatten 28 der 90 Patienten ein positives PET/CT hinsichtlich eines Rezidives, 47 Patienten wiesen ein erhöhtes S100B-Serumprotein auf. Die Sensitivität, Spezifität, PPV und NPV für die PET/CT in der Gesamtgruppe der Patienten war 87%, 93%, 87% und 93%. Die entsprechenden Werte für das Serumprotein S100B waren 65%, 52%, 43% und 74%. PET/CT-positive Patienten zeigten ein signifikant längeres Überleben (p < 0,001) als PET/CT-negative Patienten. Es konnte kein statistisch signifikanter Unterschied hinsichtlich des 5-Jahresüberlebens zwischen S100B-positiven und -negativen Patienten gefunden werden. Schlussfolgerung: Die PET/CT kann zum Nachweis oder zum Ausschluss eines Rezidives und zur Bestimmung der Prognose bei Patienten mit malignem Melanom eingesetzt werden. Die diagnostische Genauigkeit ist der des Serumproteins S100B überlegen.

 
  • References

  • 1 Balch CM, Gershenwald JE, Soong SJ. et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol 2009; 27: 6199-6206.
  • 2 Balch CM, Soong SJ, Gershenwald JE. et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001; 19: 3622-3634.
  • 3 Beyeler M, Waldispuhl S, Strobel K. et al. Detection of melanoma relapse: first comparative analysis on imaging techniques versus S100 protein. Dermatology 2006; 213: 187-191.
  • 4 Essler M, Link A, Belloni B. et al. Prognostic value of [18F]-fluoro-deoxy-glucose PET/CT, S100 or MIA for assessment of cancer-associated mortality in patients with high risk melanoma. PloS one 2011; 6: e24632.
  • 5 Fuster D, Chiang S, Johnson G. et al. Is 18F-FDG PET more accurate than standard diagnostic procedures in the detection of suspected recurrent melanoma?. J Nuc Med 2004; 45: 1323-1237.
  • 6 Garbe C, Hauschild A, Volkenandt M, Schadendorf D. Leitlinie Malignes Melanom. 2005 Vers. 15.
  • 7 Garbe C, Paul A, Kohler-Spath H. et al. Prospective evaluation of a follow-up schedule in cutaneous melanoma patients: recommendations for an effective follow-up strategy. J Clin Oncol 2003; 21: 520-529.
  • 8 Hamberg AP, Korse CM, Bonfrer JM, de Gast GC. Serum S100B is suitable for prediction and monitoring of response to chemoimmunotherapy in metastatic malignant melanoma. Melanoma Res 2003; 13: 45-49.
  • 9 Harpio R, Einarsson R. S100 proteins as cancer biomarkers with focus on S100B in malignant melanoma. Clin Biochem 2004; 37: 512-518.
  • 10 Hauschild A, Engel G, Brenner W. et al. Predictive value of serum S100B for monitoring patients with metastatic melanoma during chemotherapy and/ or immunotherapy. Br J Dermatol 1999; 140: 1065-1071.
  • 11 Kang S, Ahn BC, Hong CM. et al. Can 18F-FDG PET/CT predict recurrence in patients with cutaneous malignant melanoma?. Nuklearmedizin Nuclear medicine 2011; 50: 116-121.
  • 12 Mocellin S, Zavagno G, Nitti D. The prognostic value of serum S100B in patients with cutaneous melanoma: a meta-analysis. International journal of cancer J Int Cancer 2008; 123: 2370-2376.
  • 13 Mohammed MQ, Abraha HD, Sherwood RA. et al. Serum S100beta protein as a marker of disease activity in patients with malignant melanoma. Med Oncol 2001; 18: 109-120.
  • 14 Oberholzer PA, Urosevic M, Steinert HC, Dummer R. Baseline staging of melanoma with unknown primary site: the value of serum s100 protein and positron emission tomography. Dermatology 2008; 217: 351-355.
  • 15 Peric B, Zagar I, Novakovic S. et al. Role of serum S100B and PET-CT in follow-up of patients with cutaneous melanoma. BMC cancer 2011; 11: 328.
  • 16 Pfannenberg C, Aschoff P, Schanz S. et al. Prospective comparison of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and whole-body magnetic resonance imaging in staging of advanced malignant melanoma. Eur J Cancer 2007; 43: 557-564.
  • 17 Reinhardt MJ, Joe AY, Jaeger U. et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: experience with 250 consecutive patients. J Clin Oncol 2006; 24: 1178-1187.
  • 18 Reinhardt MJ, Kensy J, Frohmann J. et al. Value of tumour marker S-100B in melanoma patients: a comparison to 18F-FDG PET and clinical data. Nuklearmedizin 2002; 41: 143-147.
  • 19 Rinne D, Baum RP, Hör G, Kaufmann R. Primary staging and follow-up of high risk melanoma patients with whole-body 18F-fluorodeoxyglucose positron emission tomography: results of a prospective study of 100 patients. Cancer 1998; 82: 1664-1671.
  • 20 Smit LH, Korse CM, Bonfrer JM. Comparison of four different assays for determination of serum S-100B. Int J Biol Markers 2005; 20: 34-42.
  • 21 Smit LH, Nieweg OE, Mooi WJ. et al. Value of serum S-100B for prediction of distant relapse and survival in stage III B/C melanoma. Anticancer Res 2008; 28: 2297-2302.
  • 22 Swetter SM, Carroll LA, Johnson DL, Segall GM. Positron emission tomography is superior to computed tomography for metastatic detection in melanoma patients. Ann Surg Oncol 2002; 9: 646-653.
  • 23 Tarhini AA, Stuckert J, Lee S. et al. Prognostic significance of serum S100B protein in high-risk surgically resected melanoma patients participating in Intergroup Trial ECOG 1694. J Clin Oncol 2009; 27: 38-44.
  • 24 Vitzthum J, Dorr HD, Meineke V. Ultraviolet B exposure could influence the interpretation of serum S100beta levels in patients with malignant melanoma. Br J Dermatol 2007; 156: 772-773.
  • 25 Vrbic S, Filipovic S, Pejic I. et al. Sensitivity, specificity, positive and negative predictive value of serum S-100 beta protein in patients with malignant melanoma. J BUON 2003; 8: 139-141.