18FDG PET/CT SUV: A Noninvasive Biomarker For the Risk of Metastasis from Choroidal Melanoma

By Paul T. Finger, MD

In a research study, Dr. Finger compared the intensity of radioactive glucose uptake [from positron emmission tomography (PET)] to clinical, ultrasound, and pathology features of choroidal melanomas evaluated by FDG positron emission tomography / computed tomography (PET/CT). 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 performed.

Selecting out the highest 6 PET/CT standardized uptake values [(SUV) > or = to 4.0] melanomas, patients were (on average) 10 years older. in general, higher SUV tumors had larger basal dimensions, were epithelioid-cell type, were centered anterior to the equator, contained enlarged blood vessels (>150 microns in diameter), and had formed extrascleral extension.

This study suggests that PET/CT imaging offered a physiologic assessment of glucose metabolism within 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.

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