PET/CT variants and pitfalls in malignant melanoma

Cancer Imaging

Diane Kottler¹  Amir Iravani²  Nicolas Aide³  Kevin Prigent³  Ramin Alipour⁴  Rodney J. Hicks⁵ 

[1] Dermatology Department, University Hospital, Caen, France;Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, USA;PET Centre, University Hospital, Service de Médecine Nucléaire, CHU de Caen, Avenue Côte de Nacre, 14000, Caen, France;Peter MacCallum Cancer Institute, Melbourne, Australia;Peter MacCallum Cancer Institute, Melbourne, Australia;The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia;

关键词: Melanoma;    Pitfalls, variants;    FDG;    PET;    Immunotherapy;    PET technology;    COVID19;   

DOI  :  10.1186/s40644-021-00440-4

来源: Springer

【 摘 要 】

18F-FDG PET/CT plays an increasingly pivotal role in the staging and post-treatment monitoring of high-risk melanoma patients, augmented by the introduction of therapies, including tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICIs), that have novel modes of action that challenge conventional response assessment. Simultaneously, technological advances have been regularly released, including advanced reconstruction algorithms, digital PET and motion correction, which have allowed the PET community to detect ever-smaller cancer lesions, improving diagnostic performance in the context of indications previously viewed as limitations, such as detection of in-transit disease and confirmation of the nature of small pulmonary metastases apparent on CT.This review will provide advice regarding melanoma-related PET protocols and will focus on variants encountered during the imaging of melanoma patients. Emphasis will be made on pitfalls related to non-malignant diseases and treatment-related findings that may confound accurate interpretation unless recognized. The latter include signs of immune activation and immune-related adverse events (irAEs). Technology-related pitfalls are also discussed, since while new PET technologies improve detection of small lesions, these may also induce false-positive cases and require a learning curve to be observed. In these times of the COVID 19 pandemic, cases illustrating lessons learned from COVID 19 or vaccination-related pitfalls will also be described.

【 授权许可】

CC BY