A prospective analysis of ¹⁸F-FDG PET/CT in patients with uveal melanoma: comparison between metabolic rate of glucose (MRglu) and standardized uptake value (SUV) and correlations with histopathological features

Eur J Nucl Med Mol Imaging. 2013 Oct;40(11):1682-91. doi: 10.1007/s00259-013-2488-6. Epub 2013 Jul 4.

Abstract

Purpose: To evaluate whether standardized uptake value (SUV) and/or metabolic rate of glucose (MRglu) are different among epithelioid, mixed, and spindle cell uveal melanomas, as well as between low and high risk melanomas; to correlate ultrasonographic data and metabolic parameters with histopathological features; and to assess the role of (18)F-FDG PET/CT for evaluating prognosis.

Methods: Of 34 eligible patients prospectively enrolled with clinical suspicion of medium/large uveal melanoma, 26 (15 men, mean age 62.8 ± 11.8 years) were evaluated. All patients underwent metastatic work-up, 3-D dynamic brain and whole-body (18)F-FDG PET/CT, and surgery.

Results: Of the 26 ocular lesions, 23 showed (18)F-FDG uptake, with a sensitivity of 88 %. MRglu was significantly higher in the epithelioid cell melanomas than in the spindle cell melanomas, as well as in high-risk lesions than in low-risk lesions (p = 0.01, p = 0.02, respectively). SUV and MRglu were correlated with histopathological features while ultrasonographic data were not.

Conclusion: MRglu is useful for distinguishing the different cell types in uveal melanoma, as well as high-risk from low-risk lesions, while SUV is not. MRglu provides a more accurate evaluation of glucose consumption, whereas SUV provides only an estimation. In addition, the metabolic parameters correlate with histopathological features, well also reflecting cellular behaviour in ocular malignancy. A longer follow-up is needed to assess the role of (18)F-FDG in evaluating prognosis.

MeSH terms

  • Aged
  • Female
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Glucose / metabolism*
  • Humans
  • Male
  • Melanoma / diagnostic imaging*
  • Melanoma / metabolism
  • Melanoma / pathology
  • Middle Aged
  • Multimodal Imaging
  • Positron-Emission Tomography*
  • Prospective Studies
  • Radiopharmaceuticals / pharmacokinetics*
  • Tomography, X-Ray Computed
  • Uveal Neoplasms / diagnostic imaging*
  • Uveal Neoplasms / metabolism
  • Uveal Neoplasms / pathology

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Glucose