University of Groningen, University Medical Center Groningen, Department of Medical Oncology, Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Groningen, the Netherlands.
Crit Rev Oncol Hematol. 2020 Sep;153:103044. doi: 10.1016/j.critrevonc.2020.103044. Epub 2020 Jul 1.
F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is increasingly used in patients with advanced melanoma. Immune checkpoint inhibitors and BRAF/MEK-targeted therapy have transformed the therapeutic landscape of metastatic melanoma. Consequently, a need for markers predicting (early) response to treatment and for monitoring treatment (toxicity) has arisen. This systematic review appraises the current literature evidence for rational use of F-FDG PET/CT scans in staging, clinical decision-making, treatment monitoring and follow-up in advanced melanoma. F-FDG PET/CT has high overall accuracy for detection of distant metastases and is, combined with cerebral MRI, the preferred imaging strategy for staging metastatic melanoma. In contrast, strong evidence supporting the standard use of F-FDG PET/CT for predicting and monitoring therapy response and toxicity is currently lacking. Essential for determining the position of F-FDG PET/CT during treatment course in advanced melanoma are well-designed studies with standardized scanning protocols, incorporation of clinical parameters and comparison with contrast-enhanced CT alone.
正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）越来越多地用于晚期黑色素瘤患者。免疫检查点抑制剂和 BRAF/MEK 靶向治疗改变了转移性黑色素瘤的治疗格局。因此，需要能够预测（早期）治疗反应和监测治疗（毒性）的标志物。本系统评价评估了 F-FDG PET/CT 扫描在晚期黑色素瘤分期、临床决策、治疗监测和随访中的合理应用的当前文献证据。F-FDG PET/CT 对远处转移的检测具有很高的总体准确性，并且与脑部 MRI 相结合，是分期转移性黑色素瘤的首选影像学策略。相比之下，目前缺乏支持将 F-FDG PET/CT 常规用于预测和监测治疗反应和毒性的有力证据。对于确定晚期黑色素瘤治疗过程中 F-FDG PET/CT 的位置，至关重要的是采用具有标准化扫描方案、纳入临床参数并与单独增强 CT 进行比较的精心设计的研究。
