PET/CT de corpo inteiro é necessário para pacientes com melanoma?
Data
2022-08-04
Autores
Gonçalves, Mayra Coimbra
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Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: O melanoma maligno (MMelanoma) de pele é uma das neoplasias com maior letalidade e de fácil disseminação para todas as partes do corpo. A PET/CT-FDG-18F é uma ferramenta de imagem com importante papel no MMelanoma. A técnica convencional de aquisição do PET/CT-FDG-18F se estende até a raiz das coxas (RC). No entanto, na investigação do MMelanoma, a aquisição do corpo inteiro (CI) ainda é recomendada, embora tal indicação, de modo generalizado, propicie desvantagens e valor adicional questionável. Objetivo: Verificar os locais do sítio primário e de metástases de MMelanoma por meio de PET/CT-FDG-18F e a frequência de metástases isoladas não esperadas em membros superiores e inferiores de portadores de melanoma maligno com PET/CT-FDG- 18F e correlacionar com dados clínicos e resultados anatomopatológicos (AP). Casuística e Métodos: Tratou-se de um estudo transversal, observacional, descritivo, com coleta retrospectiva de dados de prontuários de 422 pacientes com MMelanoma submetidos ao PET/CT-FDG-18F CI no período de janeiro de 2016 a janeiro de 2022. Informações do estudo AP e de locais metastáticos ao PET/CT-FDG-18F foram coletadas e correlacionadas, considerando nível de significância p< 0,05 e poder estatístico mínimo de 80%. Resultados: Não foi identificada nenhuma metástase isolada em membros superiores (MMSS) ou inferiores (MMII). Em média, cada paciente apresentou 3,18 ± 2,25 locais de metástases, variando de um a onze, sendo ao menos uma na região de tronco. O pulmão foi o local mais frequente. Conclusão: A PETCT-FDG-18F CI não mostrou valor adicional em comparação ao protocolo RC para o estadiamento e manejo terapêutico do MMelanoma. Protocolos otimizados de aquisição podem ser indicados.
Introduction: Malignant melanoma (MMelanoma) of the skin is one of the most lethal neoplasms and is easily spread to all parts of the body. The conventional technique of PET/CT-FDG-18F acquisition extends to the root of the thighs (RT). However, in the investigation of MMelanoma, whole-body (WB) acquisition is still recommended, although such an indication, in general, has disadvantages and questionable additional value. Objective: Verify the locals of the primary site and MMelanoma metastases using PET/CT-FDG-18F and the frequency of unexpected isolated metastases in upper and lower limbs of patients with malignant melanoma with PET/CT-FDG-18F and correlate with clinical data and anatomopathological (AP) results. Methods: It was a cross-sectional, observational, descriptive study with retrospective data collection from the medical records of 422 patients with MMelanoma who underwent whole-body PET/CT-FDG-18F from January 2016 to January 2022. Information from the AP study and from metastatic sites on PET/CT-FDG-18F were collected and correlated, considering a significance level of p<0.05 and a minimum statistical power of 80%. Results: None isolated metastasis was identified in the upper (ULM) or lower (LL) limbs. On average, each patient had 3.18 ± 2.25 metastasis sites, ranging from one to eleven, with at least one in the trunk region. The lung was the most frequent site. Conclusion: WB PET/CT showed no additional value compared to the RT protocol for the staging and therapeutic management of MMelanoma. Optimized acquisition protocols can be indicated.
Introduction: Malignant melanoma (MMelanoma) of the skin is one of the most lethal neoplasms and is easily spread to all parts of the body. The conventional technique of PET/CT-FDG-18F acquisition extends to the root of the thighs (RT). However, in the investigation of MMelanoma, whole-body (WB) acquisition is still recommended, although such an indication, in general, has disadvantages and questionable additional value. Objective: Verify the locals of the primary site and MMelanoma metastases using PET/CT-FDG-18F and the frequency of unexpected isolated metastases in upper and lower limbs of patients with malignant melanoma with PET/CT-FDG-18F and correlate with clinical data and anatomopathological (AP) results. Methods: It was a cross-sectional, observational, descriptive study with retrospective data collection from the medical records of 422 patients with MMelanoma who underwent whole-body PET/CT-FDG-18F from January 2016 to January 2022. Information from the AP study and from metastatic sites on PET/CT-FDG-18F were collected and correlated, considering a significance level of p<0.05 and a minimum statistical power of 80%. Results: None isolated metastasis was identified in the upper (ULM) or lower (LL) limbs. On average, each patient had 3.18 ± 2.25 metastasis sites, ranging from one to eleven, with at least one in the trunk region. The lung was the most frequent site. Conclusion: WB PET/CT showed no additional value compared to the RT protocol for the staging and therapeutic management of MMelanoma. Optimized acquisition protocols can be indicated.
Descrição
Palavras-chave
Melanoma, PET/CT, PET/CT corpo inteiro, Whole-body PET/CT