PET/CT SUV Intensity Correlated to Known Risk Factors for Metastasis from Choroidal Melanoma

The authors of a recently published study in the British Journal of Ophthalmology correlated the clinical, ultrasound, and pathology features of eyes evaluated by FDG positron emission tomography / computed tomography (PET/CT) then enucleated for choroidal melanoma.

Pre-operative ultrasound was used to measure tumor size, evaluate tumor shape and intrinsic vascularity (blood flow). Histopathology and immunohistochemical evaluations of tumor cell-type, necrosis, glycogen-content, vascularity and extrascleral extension were also performed.

PET/CT standardized uptake value (SUV) is a measure of the metabolic activity of the choroidal melanoma.
By selecting out the highest 6 standardized uptake values [(SUV) > or = to 4.0] melanomas, patients were (on average) 10 years older and had larger basal dimensions. These two characteristics are COMS-proven risk factors for metastasis from choroidal melanoma.

In addition, higher SUV tumors were more commonly epithelioid-cell type, centered anterior to the equator, contained enlarged blood vessels (>150 microns in diameter), and had formed extrascleral extension (also considered risk factors in other studies). The two highest SUV tumors had caused death from metastatic melanoma.

The authors found that PET/CT imaging offered a physiologic assessment of glucose metabolism within primary choroidal melanomas. Increased FDG PET/CT SUV ( > or = to 4.0) was positively correlated to known clinical, pathology and ultrasound features linked to metastatic potential of choroidal melanoma.

Related Links

Read the article as it appeared in the British Journal of Ophthalmology

Read an article that shows that tumor size also affects the ability of PET/CT to image choroidal melanoma

Read an article on how PET/CT is being used to screen for choroidal melanoma metastasis before surgery

Read an article showing the greater sensitivity of PET/CT for finding metastasis (particularly in bone).

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