Positron emission tomography/computed tomography imaging in Merkel cell carcinoma: a study of 270 scans in 97 patients at the Dana-Farber/Brigham and Women's Cancer Center.

Autor: Hawryluk EB; Department of Dermatology, Harvard Medical School, Boston, Massachusetts., O'Regan KN; Department of Imaging, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts., Sheehy N; Department of Imaging, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts., Guo Y; Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Dorosario A; Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts., Sakellis CG; Department of Imaging, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts., Jacene HA; Department of Imaging, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts., Wang LC; Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Center for Cutaneous Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts. Electronic address: lwang@mdmercy.com.
Jazyk: angličtina
Zdroj: Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2013 Apr; Vol. 68 (4), pp. 592-599. Date of Electronic Publication: 2012 Nov 03.
DOI: 10.1016/j.jaad.2012.08.042
Abstrakt: Background: Merkel cell carcinoma (MCC) is a rare and lethal cutaneous neuroendocrine carcinoma. Imaging is crucial for accurate staging, which remains a strong predictor of survival, as well as earlier detection of recurrence and progression, which are common despite aggressive management. There is no consensus on the role of initial and subsequent imaging for MCC.
Objective: We sought to evaluate the use of 2-fluoro-[(18)F]-deoxy-2-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the management of MCC.
Methods: In all, 270 FDG-PET/CT studies were performed in 97 patients with pathology-proven MCC at the Dana-Farber/Brigham and Women's Cancer Center, Boston, Mass, from August 2003 to December 2010.
Results: FDG-PET/CT scans were obtained as part of the initial (61 scans in 61 patients) and subsequent (209 scans in 79 patients) treatment strategies. MCCs were FDG-avid with a mean maximum standardized uptake value of primary lesions of 6.5 (range 1.3-12.9) and a mean maximum standardized uptake value of regional and distant metastases of 7.2 (range 1.5-9.9). FDG-PET/CT upstaged 16% of patients who underwent baseline scans. FDG-PET/CT studies showed that bone and bone-marrow metastases were more common than previously reported, and were often undetected by CT.
Limitations: Our study is limited by its retrospective design, and potential referral bias associated with a tertiary care center.
Conclusions: FDG-PET/CT performed as part of the initial management strategy tended to upstage patients with more advanced disease. FDG-PET/CT performed as part of the subsequent treatment strategy identified metastatic disease, particularly in bone/bone marrow, which was not seen on CT. FDG-PET/CT imaging is a valuable staging and restaging tool in MCC management.
(Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)
Databáze: MEDLINE
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