Malignant melanoma, known for its aggressive nature and high potential for metastasis, holds the highest mortality rate among skin cancers. Significantly, melanoma is also the third most frequent source of metastatic brain tumors, contributing to approximately 10% of all brain metastases. While F-18 FDG-PET/CT is recognized as an effective imaging technique for detecting melanoma metastases, its baseline prognostic significance in these cases is not well-documented. Now a new study has found that PET/CT scans might be capable of predicting the development of brain metastases in patients with melanoma

A team of researchers at the University Hospital Salzburg (Salzburg, Austria) conducted a retrospective study focusing on baseline F-18 FDG-PET/CT imaging parameters in melanoma patients. Their study linked these parameters to the onset of metastatic brain tumors. The research involved 159 consecutive melanoma patients who underwent F-18 FDG-PET/CT imaging at the hospital from 2008 to 2021 for initial staging and subsequent brain metastasis diagnosis during follow-ups. Baseline parameters from the PET/CT images were extracted and examined against the development of brain metastases using risk regression models. The median duration of follow-up was six years.

The study's results demonstrated that higher baseline peak standardized uptake values (pSULpeak), indicating maximum FDG radiotracer activity in the tumor, correlated with an increased and accelerated risk of brain tumors. For instance, a pSULpeak value of 19 translated to an 80% risk of brain metastasis within approximately 53 months, while a value of 26 indicated the same risk level within about 39 months. Therefore, higher baseline pSULpeak values increased the likelihood and hastened the onset of brain metastases in patients. These insights could enable healthcare providers to better identify patients who may need more frequent monitoring or could benefit from additional preventive treatments.

“Our results may suggest that in addition to clinical and pathological characteristics of tumors, F-18 FDG-PET/CT findings can be of value for prognostic risk stratification considering the occurrence of brain metastasis,” stated the researchers. 

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