Positron emission tomography/computed tomography imaging in Merkel cell carcinoma: A study of 270 scans in 97 patients at the Dana-Farber/Brigham and Women's Cancer Center

Elena B. Hawryluk, Kevin N. O'Regan, Niall Sheehy, Ye Guo, Andrew Dorosario, Christopher G. Sakellis, Heather A. Jacene, Linda C. Wang

Research output: Contribution to journalArticle

Abstract

Background: Merkel cell carcinoma (MCC) is a rare and lethal cutaneous neuroendocrine carcinoma. Imaging is crucial for accurate staging, which remains a strong predictor of survival, as well as earlier detection of recurrence and progression, which are common despite aggressive management. There is no consensus on the role of initial and subsequent imaging for MCC. Objective: We sought to evaluate the use of 2-fluoro-[18F]-deoxy-2-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the management of MCC. Methods: In all, 270 FDG-PET/CT studies were performed in 97 patients with pathology-proven MCC at the Dana-Farber/Brigham and Women's Cancer Center, Boston, Mass, from August 2003 to December 2010. Results: FDG-PET/CT scans were obtained as part of the initial (61 scans in 61 patients) and subsequent (209 scans in 79 patients) treatment strategies. MCCs were FDG-avid with a mean maximum standardized uptake value of primary lesions of 6.5 (range 1.3-12.9) and a mean maximum standardized uptake value of regional and distant metastases of 7.2 (range 1.5-9.9). FDG-PET/CT upstaged 16% of patients who underwent baseline scans. FDG-PET/CT studies showed that bone and bone-marrow metastases were more common than previously reported, and were often undetected by CT. Limitations: Our study is limited by its retrospective design, and potential referral bias associated with a tertiary care center. Conclusions: FDG-PET/CT performed as part of the initial management strategy tended to upstage patients with more advanced disease. FDG-PET/CT performed as part of the subsequent treatment strategy identified metastatic disease, particularly in bone/bone marrow, which was not seen on CT. FDG-PET/CT imaging is a valuable staging and restaging tool in MCC management.

Original languageEnglish (US)
Pages (from-to)592-599
Number of pages8
JournalJournal of the American Academy of Dermatology
Volume68
Issue number4
DOIs
StatePublished - 2013
Externally publishedYes

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Merkel Cell Carcinoma
Neoplasms
Bone Marrow
Tomography
Neoplasm Metastasis
Neuroendocrine Carcinoma
Bone and Bones
Positron Emission Tomography Computed Tomography
Fluorodeoxyglucose F18
Tertiary Care Centers
Referral and Consultation
Pathology
Recurrence
Skin
Survival

Keywords

  • 2-fluoro-[F]-deoxy-2-D-glucose
  • computed tomography
  • imaging
  • Merkel cell carcinoma
  • metastasis
  • positron emission tomography
  • staging

ASJC Scopus subject areas

  • Dermatology

Cite this

Positron emission tomography/computed tomography imaging in Merkel cell carcinoma : A study of 270 scans in 97 patients at the Dana-Farber/Brigham and Women's Cancer Center. / Hawryluk, Elena B.; O'Regan, Kevin N.; Sheehy, Niall; Guo, Ye; Dorosario, Andrew; Sakellis, Christopher G.; Jacene, Heather A.; Wang, Linda C.

In: Journal of the American Academy of Dermatology, Vol. 68, No. 4, 2013, p. 592-599.

Research output: Contribution to journalArticle

Hawryluk, Elena B. ; O'Regan, Kevin N. ; Sheehy, Niall ; Guo, Ye ; Dorosario, Andrew ; Sakellis, Christopher G. ; Jacene, Heather A. ; Wang, Linda C. / Positron emission tomography/computed tomography imaging in Merkel cell carcinoma : A study of 270 scans in 97 patients at the Dana-Farber/Brigham and Women's Cancer Center. In: Journal of the American Academy of Dermatology. 2013 ; Vol. 68, No. 4. pp. 592-599.
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abstract = "Background: Merkel cell carcinoma (MCC) is a rare and lethal cutaneous neuroendocrine carcinoma. Imaging is crucial for accurate staging, which remains a strong predictor of survival, as well as earlier detection of recurrence and progression, which are common despite aggressive management. There is no consensus on the role of initial and subsequent imaging for MCC. Objective: We sought to evaluate the use of 2-fluoro-[18F]-deoxy-2-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the management of MCC. Methods: In all, 270 FDG-PET/CT studies were performed in 97 patients with pathology-proven MCC at the Dana-Farber/Brigham and Women's Cancer Center, Boston, Mass, from August 2003 to December 2010. Results: FDG-PET/CT scans were obtained as part of the initial (61 scans in 61 patients) and subsequent (209 scans in 79 patients) treatment strategies. MCCs were FDG-avid with a mean maximum standardized uptake value of primary lesions of 6.5 (range 1.3-12.9) and a mean maximum standardized uptake value of regional and distant metastases of 7.2 (range 1.5-9.9). FDG-PET/CT upstaged 16{\%} of patients who underwent baseline scans. FDG-PET/CT studies showed that bone and bone-marrow metastases were more common than previously reported, and were often undetected by CT. Limitations: Our study is limited by its retrospective design, and potential referral bias associated with a tertiary care center. Conclusions: FDG-PET/CT performed as part of the initial management strategy tended to upstage patients with more advanced disease. FDG-PET/CT performed as part of the subsequent treatment strategy identified metastatic disease, particularly in bone/bone marrow, which was not seen on CT. FDG-PET/CT imaging is a valuable staging and restaging tool in MCC management.",
keywords = "2-fluoro-[F]-deoxy-2-D-glucose, computed tomography, imaging, Merkel cell carcinoma, metastasis, positron emission tomography, staging",
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T1 - Positron emission tomography/computed tomography imaging in Merkel cell carcinoma

T2 - A study of 270 scans in 97 patients at the Dana-Farber/Brigham and Women's Cancer Center

AU - Hawryluk, Elena B.

AU - O'Regan, Kevin N.

AU - Sheehy, Niall

AU - Guo, Ye

AU - Dorosario, Andrew

AU - Sakellis, Christopher G.

AU - Jacene, Heather A.

AU - Wang, Linda C.

PY - 2013

Y1 - 2013

N2 - Background: Merkel cell carcinoma (MCC) is a rare and lethal cutaneous neuroendocrine carcinoma. Imaging is crucial for accurate staging, which remains a strong predictor of survival, as well as earlier detection of recurrence and progression, which are common despite aggressive management. There is no consensus on the role of initial and subsequent imaging for MCC. Objective: We sought to evaluate the use of 2-fluoro-[18F]-deoxy-2-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the management of MCC. Methods: In all, 270 FDG-PET/CT studies were performed in 97 patients with pathology-proven MCC at the Dana-Farber/Brigham and Women's Cancer Center, Boston, Mass, from August 2003 to December 2010. Results: FDG-PET/CT scans were obtained as part of the initial (61 scans in 61 patients) and subsequent (209 scans in 79 patients) treatment strategies. MCCs were FDG-avid with a mean maximum standardized uptake value of primary lesions of 6.5 (range 1.3-12.9) and a mean maximum standardized uptake value of regional and distant metastases of 7.2 (range 1.5-9.9). FDG-PET/CT upstaged 16% of patients who underwent baseline scans. FDG-PET/CT studies showed that bone and bone-marrow metastases were more common than previously reported, and were often undetected by CT. Limitations: Our study is limited by its retrospective design, and potential referral bias associated with a tertiary care center. Conclusions: FDG-PET/CT performed as part of the initial management strategy tended to upstage patients with more advanced disease. FDG-PET/CT performed as part of the subsequent treatment strategy identified metastatic disease, particularly in bone/bone marrow, which was not seen on CT. FDG-PET/CT imaging is a valuable staging and restaging tool in MCC management.

AB - Background: Merkel cell carcinoma (MCC) is a rare and lethal cutaneous neuroendocrine carcinoma. Imaging is crucial for accurate staging, which remains a strong predictor of survival, as well as earlier detection of recurrence and progression, which are common despite aggressive management. There is no consensus on the role of initial and subsequent imaging for MCC. Objective: We sought to evaluate the use of 2-fluoro-[18F]-deoxy-2-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the management of MCC. Methods: In all, 270 FDG-PET/CT studies were performed in 97 patients with pathology-proven MCC at the Dana-Farber/Brigham and Women's Cancer Center, Boston, Mass, from August 2003 to December 2010. Results: FDG-PET/CT scans were obtained as part of the initial (61 scans in 61 patients) and subsequent (209 scans in 79 patients) treatment strategies. MCCs were FDG-avid with a mean maximum standardized uptake value of primary lesions of 6.5 (range 1.3-12.9) and a mean maximum standardized uptake value of regional and distant metastases of 7.2 (range 1.5-9.9). FDG-PET/CT upstaged 16% of patients who underwent baseline scans. FDG-PET/CT studies showed that bone and bone-marrow metastases were more common than previously reported, and were often undetected by CT. Limitations: Our study is limited by its retrospective design, and potential referral bias associated with a tertiary care center. Conclusions: FDG-PET/CT performed as part of the initial management strategy tended to upstage patients with more advanced disease. FDG-PET/CT performed as part of the subsequent treatment strategy identified metastatic disease, particularly in bone/bone marrow, which was not seen on CT. FDG-PET/CT imaging is a valuable staging and restaging tool in MCC management.

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KW - computed tomography

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KW - Merkel cell carcinoma

KW - metastasis

KW - positron emission tomography

KW - staging

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