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Restaging [18F] fludeoxyglucose positron emission tomography/computed tomography scan in recurrent cutaneous squamous cell carcinoma: Diagnostic performance and prognostic significance - 13/03/20

Doi : 10.1016/j.jaad.2019.09.035 
Sonia Mahajan, MD a, Christopher A. Barker, MD b, Audrey Mauguen, PhD c, Bhuvanesh Singh, MD d, Neeta Pandit-Taskar, MD a,
a Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York 
b Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 
c Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York 
d Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York 

Correspondence to: Neeta Pandit-Taskar, MD, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065.Memorial Sloan Kettering Cancer Center1275 York AveNew YorkNY10065

Abstract

Background

There are no specific recommendations for [18F] fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in assessing recurrent cutaneous squamous cell carcinoma (cSCC).

Objective

To evaluate FDG-PET/CT in recurrent cSCC.

Methods

FDG-PET/CT scans were retrospectively reviewed. Sites of abnormal uptake were noted and correlated with biopsy/histopathology studies, where available, and with follow-up imaging or clinical data in others. Comparison with available CT/magnetic resonance imaging was performed. The prognostic significance of PET/CT parameters was evaluated, and PET/CT-based change in management was recorded.

Results

A total of 115 FDG-PET/CT scans were analyzed in 100 consecutive patients with cSCC. Of these, 96 (84%) scans were positive for recurrence, and 25 showed distant metastases. PET/CT detected unsuspected disease sites in 39 of 115 scans (34%), locoregional disease in 14, distant metastases in 11, both locoregional disease and distant metastases in 8, additional local cutaneous disease in 5, and second malignancy in 1. Comparison of 78 PET/CT scans with available CT/magnetic resonance imaging showed 37 additional abnormalities on 23 PET/CT scans, predominantly including skin/subcutaneous lesions and nodes. PET/CT led to change in management in 28% of patients. On univariate/multivariate analysis, increased number of FDG-positive lesions and lung metastases on PET/CT was associated with increased risk of death/disease progression.

Limitations

Retrospective study.

Conclusions

FDG-PET/CT was sensitive in detecting recurrent disease in cSCC, led to change in management for 28% of patients, and proved to be of prognostic value.

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Key words : cutaneous, FDG-PET/CT, neoplasm, oncology, positron emission tomography, prognosis, recurrent, restaging, squamous cell carcinoma

Abbreviations used : cSCC, CI, CT, FDG, HR, MR, PET, SUV, TTP


Plan


 Funding sources: Supported in part through the National Institutes of Health/National Cancer Institute Cancer Center support grant P30 CA008748.
 Disclosure: Dr Pandit-Taskar has served as a consultant to Y-mAbs Therapeutics, Inc; has served on the advisory board of Progenics; has received honoraria from Progenics and MedImmune/AstraZeneca; and has conducted funded research studies with ImaginAb. Dr Barker reports grants from Amgen, Elekta, and Merck outside the submitted work. Drs Mahajan, Mauguen, and Singh have no conflicts of interest to declare.
 IRB approval status: Reviewed and approved by MSKCC's institutional review board.
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 82 - N° 4

P. 878-886 - avril 2020 Retour au numéro
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