Abstract

DO.08.02

Whole-body Positron Emission Tomography/Computed tomography (PET/CT) imaging in the follow-up of metastatic uveal melanoma

Annemarie Klingenstein1, Alexander Haug2, Martin M. Nentwich1, Reinhold Tiling2, Ulrich C. Schaller1
1Augenklinik der Ludwig-Maximilians-Universität München, München; 2Klinik für Nuklearmedizin der Ludwig-Maximilians Universität München, München

Objective
The uveal melanoma is the most frequent primary intraocular tumor in adults. Metastatic disease has been reported in the follow-up of up to 50% of patients. Established oncological diagnostic modalities in tumor follow-up so far only dispose of limited sensitivity and specifity.
The diagnostic value of combined positron emission tomography (PET) / computer tomography (CT) in the follow-up of patients with metastatic uveal melanoma was assessed.
Methods
Nine patients with successfully treated uveal melanoma underwent combined PET/CT. The indication for PET/CT was heterogenous and reached from suspected metastatic choroidal melanoma in conventional imaging (n=2) to exclusion of further organ involvement before local therapy of liver metastases (n=3) and restaging after local or systemic therapy of metastases (n=4).
Results
PET/CT revealed vital metastases from uveal melanoma in all patients (n=9). 8 patients showed hepatic (89%), 5 patients osseous (56%), one patient pulmonary (11%), one patient adrenal (11%) and 3 patients lymphatic metastases (33%). 5 patients showed multiple organ involvement (56%). Additionally, PET/CT could rule out pulmonary metastatic involvement with suspicious intrapulmonary findings in CT and chest-X-ray in 2 patients. It could also confirm an equivocal intrahepatic finding in MRI as a vital metastasis.
Conclusions
Accurate whole-body-staging is of eminent importance both for the determination of adequate therapy (local versus systemic) and assessment of therapy response. In our retrospective study, PET/CT proved as a very sensitive and specific tool for the detection and localization of metastatic disease. In one single examination, it was able to assess both anatomic morphology as well as cell metabolism.

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