J Korean Soc Radiol.  2019 Nov;80(6):1132-1144. 10.3348/jksr.2019.80.6.1132.

Prognostic Significance of the Imaging Parameters of Adipose Tissue and Bone Marrow on F-18 Fluorodeoxyglucose PET/CT in Patients with Malignant Melanoma

• Lee JH
• Lee SM
• Kim JE

• KMID: 2464912
• DOI: http://doi.org/10.3348/jksr.2019.80.6.1132

Abstract

PURPOSE
Fluorodeoxyglucose (FDG) uptake of bone marrow (BM) and adipose tissue is known to reflect systemic inflammatory response to cancer cell. The objective of this study was to evaluate the prognostic value of F-18 FDG uptake of BM and determine characteristics of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) on PET/CT images in malignant melanoma.
MATERIALS AND METHODS
We retrospectively reviewed 33 patients histopathologically diagnosed with malignant melanoma via FDG PET/CT staging. BM-to-liver uptake ratio (BLR), volume of VAT and SAT, CT Hounsfield unit (HU), and mean of standardized uptake value (SUVmean) of VAT and SAT on PET/CT were measured and prognostic values of these parameters for prediction of disease progression-free survival (DPFS) were evaluated.
RESULTS
Patients with stage III-IV melanoma had higher CT HU and SUVmean for SAT and VAT but lower volume of VAT compared with patients at stage I-II (p < 0.05). Survival analysis, patients with high CT HU of VAT and SAT, high SUVmean of VAT and SAT, and high BLR showed worse DPFS (all p < 0.05), indicating significant association. However, volume of SAT or VAT failed to show significant association with DPFS (p > 0.05).
CONCLUSION
CT HU, SUVmean of SAT and VAT, and BLR provide prognostic information for DPFS in malignant melanoma.

MeSH Terms

Adipose Tissue*
Bone Marrow*
Disease-Free Survival
Humans
Inflammation
Intra-Abdominal Fat
Melanoma*
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Prognosis
Retrospective Studies
Subcutaneous Fat

Figure

• 

  Fig. 1. Example of measurement of adipose tissue. A, B. On consecutive transaxial CT images at L3/L4 level. The area of adipose tissue was automatically computed using a CT attenuation range from −50 to −200 HU. C, D. Within the areas of adipose tissue on the 3 images, the volume and mean HU were automatically calculated. E, F. The areas of adipose tissue on the 3 CT images were then exported to the corresponding fluorodeoxy-glucose PET/CT images. HU = Hounsfield unit

• 

  Fig. 2. Example of measurement of bone marrow. Maximum intensity projection (A), sagittal PET (B), and sagittal fused PET/CT images of FDG PET/ CT (C). Spheroid-shaped five VOIs were drawn in vertebral bodies of thoracic and lumbar spines, and the average SUV of those VOIs was calculated. Primary malignant lesion was located left toe (arrow). FDG = fluorodeoxyglucose, SUV = standardized uptake value, VOI = volume of interest

• 

  Fig. 3. Kaplan-Meier curves for distant progression-free survival according to different parameters: BLR (A), SUV of VAT (B), SUV of SAT (C), HU of VAT (D), HU of SAT (E), and stage (F). BLR = bone marrow-to-liver uptake ratio, SAT = subcutaneous adipose tissue, SUV = standardized uptake value, HU = Hounsfield unit, VAT = visceral adipose tissue

Reference

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