Evaluation of 68Ga- and 177Lu-DOTA-PEG4-LLP2A for VLA-4-Targeted PET Imaging and Treatment of Metastatic Melanoma

Abstract Purpose Metabolically active tumour volume (MATV) is a potential quantitative positron emission tomography (PET) imaging biomarker in melanoma. Accumulating data indicate that low MATV may predict increased chance of response to immunotherapy and overall survival. However, metastatic melanoma can present with numerous (small) tumour lesions, making manual tumour segmentation time-consuming. The aim of this study was to evaluate multiple semi-automatic segmentation workflows to determine reliability and reproducibility of MATV measurements in patients with metastatic melanoma. Methods An existing cohort of 64 adult patients with histologically proven metastatic melanoma was used in this study. 18F-FDG PET/CT diagnostic baseline images were acquired using a European Association of Nuclear Medicine (EANM) Research Limited–accredited Siemens Biograph mCT PET/CT system (Siemens Healthineers, Knoxville, USA). PET data were analysed using manual, gradient-based segmentation and five different semi-automatic methods: three direct PET image–derived delineations (41MAX, A50P and SUV40) and two based on a majority-vote approach (MV2 and MV3), without and with (suffix ‘+’) manual lesion addition. Correlation between the different segmentation methods and their respective associations with overall survival was assessed. Results Correlation between the MATVs derived by the manual segmentation and semi-automated tumour segmentations ranged from R2 = 0.41 for A50P to R2 = 0.85 for SUV40+ and MV2+, respectively. Manual MATV segmentation did not differ significantly from the semi-automatic methods SUV40 (∆MATV mean ± SD 0.08 ± 0.60 mL, P = 0.303), SUV40+ (∆MATV − 0.10 ± 0.51 mL, P = 0.126), MV2+ (∆MATV − 0.09 ± 0.62 mL, P = 0.252) and MV3+ (∆MATV − 0.03 ± 0.55 mL, P = 0.615). Log-rank tests showed statistically significant overall survival differences between above and below median MATV patients for all segmentation methods with areas under the ROC curves of 0.806 for manual segmentation and between 0.756 [41MAX] and 0.807 [MV3+] for semi-automatic segmentations. Conclusions Simple and fast semi-automated FDG PET segmentation workflows yield accurate and reproducible MATV measurements that correlate well with manual segmentation in metastatic melanoma. The most readily applicable and user-friendly SUV40 method allows feasible MATV measurement in prospective multicentre studies required for validation of this potential PET imaging biomarker for clinical use.

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18F-BMS986192 PET imaging of PD-L1 in metastatic melanoma patients with brain metastases treated with immune checkpoint inhibitors. A pilot study.

Journal of Nuclear Medicine ◽

10.2967/jnumed.121.262368 ◽

2021 ◽

pp. jnumed.121.262368

Author(s):

Pieter H Nienhuis ◽

Ines F. Antunes ◽

Andor W.J.M. Glaudemans ◽

Mathilde Jalving ◽

David Leung ◽

...

Keyword(s):

Pilot Study ◽

Brain Metastases ◽

Metastatic Melanoma ◽

Pet Imaging ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Melanoma Patients

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WHOLE-BODY PET IMAGING IN DETECTION OF METASTATIC MELANOMA

Clinical Nuclear Medicine ◽

10.1097/00003072-199409000-00041 ◽

1994 ◽

Vol 19 (9) ◽

pp. 842

Author(s):

T. R. POUNDS ◽

P. E. VALK ◽

M. K. HASEMAN ◽

R. W. MYERS ◽

C. L. LUTRIN

Keyword(s):

Metastatic Melanoma ◽

Pet Imaging ◽

Whole Body

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False-Negative FDG PET Imaging in a Patient With Metastatic Melanoma and Ileal Intussusception

Clinical Nuclear Medicine ◽

10.1097/00003072-199902000-00015 ◽

1999 ◽

Vol 24 (2) ◽

pp. 129 ◽

Cited By ~ 5

Author(s):

HALUK ALIBAZOGLU ◽

BUKET ALIBAZOGLU ◽

AMJAD ALI ◽

GREGORY La MONICA

Keyword(s):

Metastatic Melanoma ◽

Pet Imaging ◽

Fdg Pet ◽

False Negative

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Preclinical PET imaging of glycoprotein non-metastatic melanoma B in triple negative breast cancer: feasibility of an antibody-based companion diagnostic agent

Oncotarget ◽

10.18632/oncotarget.22228 ◽

2017 ◽

Vol 8 (61) ◽

pp. 104303-104314 ◽

Cited By ~ 3

Author(s):

Bernadette V. Marquez-Nostra ◽

Supum Lee ◽

Richard Laforest ◽

Laura Vitale ◽

Xingyu Nie ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Melanoma ◽

Triple Negative Breast Cancer ◽

Pet Imaging ◽

Triple Negative ◽

Preclinical Pet ◽

Companion Diagnostic ◽

Diagnostic Agent

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The usefulness of positron emission tomography (PET) scanning to identify early recurrent melanoma in high risk resected stage III and IV patients: A retrospective review

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.8566 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 8566-8566

Author(s):

L. A. Kottschade ◽

V. Lowe ◽

S. N. Markovic

Keyword(s):

High Risk ◽

Malignant Melanoma ◽

Metastatic Melanoma ◽

Pet Imaging ◽

Retrospective Review ◽

Stage Iii ◽

Pet Scanning ◽

Complete Surgical Resection ◽

Resected Stage

8566 Background: The incidence of malignant melanoma has risen dramatically over the past decades. Prognosis for patients with metastatic melanoma is poor and treatment options are limited. Complete surgical resection is frequently front line therapy for patients with resectable metastases. However this is only an option if relapse is diagnosed early. PET imaging using 2-flourine-18, 2-fluro-2-deoxy-D-glucose (FDG) has been used successfully for staging of metastatic melanoma. However it's usefulness in surveillance for patients at high-risk of relapse (resected stage III and IV disease) has not been well studied. We conducted a retrospective review of our institutional experience using PET scanning as part of regular follow up in patients with resected stage III or IV melanoma for the purpose of detection of early recurrence. Methods: Retrospective review of the medical records of 667 consecutive patients seen at Mayo Clinic from 12/13/1999–1/1/2007, with the diagnosis of malignant melanoma for whom PET imaging was performed or reviewed at our institution. Eligibility criteria included: resected stage III or IV melanoma with at least 2 PET scans (<1 year apart) as part of regular clinical follow-up (surveillance). Frequency of PET scanning was variable and at physician discretion. Results: Of the 667 patients, 110 patients were deemed eligible for review. There were 98 recurrences among 65 patients. Of these 37 recurrences (38%) were found by PET scanning alone (asymptomatic); 61 recurrences (62%) were found by other methods (physical exam, CT, MRI, etc). Of the 37 recurrences found by routine PET scanning 17 (46%) were completely resected; of the other 61 recurrences found by other methods 33 (54%) were completely resected. Conclusions: PET scanning as regular surveillance for patients with high risk melanoma, may be a useful tool in early identification of asymptomatic melanoma relapse amenable to complete surgical resection (additional 1/3 of cases). Considering the potential clinical benefit of completely resected melanoma relapse, and the retrospective nature of this review, these data are hypothesis-generating and warrant further investigation. No significant financial relationships to disclose.

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