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. 2005 Oct;89(10):1270-4.
doi: 10.1136/bjo.2005.069823.

Whole body PET/CT for initial staging of choroidal melanoma

P T Finger  1 , M Kurli, S Reddy, L B Tena, A C Pavlick
Affiliations

Whole body PET/CT for initial staging of choroidal melanoma

P T Finger et al. Br J Ophthalmol. 2005 Oct.

Abstract

Aim: To investigate the value of whole body positron emission tomography/computed tomography (PET/CT) in screening for metastatic choroidal melanoma in patients initially diagnosed with choroidal melanoma.

Methods: 52 patients with choroidal melanoma underwent whole body PET/CT as part of their metastatic investigation. PET/CT scans were used as a screening tool at the time of their initial diagnosis. A physical examination, liver function tests, and a baseline chest x ray were also obtained. PET/CT images (utilising intravenous18-fluoro-2-deoxyglucose (FDG)) were studied for the presence of metastatic melanoma. The standards for reference were further imaging and/or subsequent biopsies.

Results: Two of 52 (3.8%) patients were found to have metastatic melanoma before treatment. The most common sites for metastases were the liver (100%), bone (50%), and lymph nodes (50%). Brain involvement was also present in one patient. One patient (50%) had involvement of multiple sites. Haematological liver enzyme assays were normal in both patients. PET/CT showed false positive results in three patients (5.7%) when further evaluated by histopathology and/or additional imaging. In seven patients (13.4%) PET/CT imaging detected benign lesions in the bone, lung, lymph nodes, colon, and rectum.

Conclusion: PET/CT imaging can be used as a screening tool for the detection and localisation of metastatic choroidal melanoma. Liver enzyme assays did not identify liver metastases, while PET/CT revealed both hepatic and extrahepatic metastatic melanoma. PET/CT imaging may improve upon the conventional methods of screening for detection of metastatic disease in patients initially diagnosed with choroidal melanoma.

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Figures

Figure 1
Figure 1
Patient 1. PET/CT fused coronal images demonstrate multiple areas of high SUV FDG uptake in the liver that correspond to low attenuation lesions seen on the transmission CT scan. These lesions were compatible with metastasis (arrow).
Figure 2
Figure 2
Patient 2. Abnormal PET/CT fused transaxial scans demonstrate diffuse metastatic lesions involving the liver.
Figure 3
Figure 3
Patient 2. PET/CT fused sagittal images demonstrate high SUV metastatic melanoma in multiple vertebrae (arrows).
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