title: Metabolic activity of primary uveal melanoma on PET/CT scan and its relationship with monosomy 3 and other prognostic factors.
abstract: OBJECTIVE
  To correlate the metabolic activity of primary uveal melanoma on positron emission tomography (PET)/CT scan with known clinical and pathological prognostic factors.
  
  
  METHODS
  A retrospective cohort analysis of eyes enucleated for uveal melanoma that underwent preoperative imaging with a PET/CT scan was performed. Tumour dimensions were recorded and classified using Collaborative Ocular Melanoma Study (COMS) and American Joint Committee on Cancer (AJCC) Tumour - Nodes - Metastases (TNM) criteria. Metabolic activity was determined by measurement of the maximal standardised uptake value (SUVmax) on PET/CT scans. SUVmax of >2.5 and >4 was also used as cut-off value for metabolic positivity. Chromosome 3 and 8 status was determined using fluorescence in situ hybridisation analysis. Pearson correlation, χ(2) test and non-parametric tests were used. p<0.05 was considered statistically significant.
  
  
  RESULTS
  Seventy-six uveal melanomas were imaged preoperatively with a PET/CT scan. Overall 92% of tumours had a SUVmax >2.5 and 67% had a SUVmax >4. Monosomy 3 was found in 35 melanomas, of which 94% had an SUVmax >2.5 and 80% had an SUVmax >4. Only 57% of disomy 3 melanomas had an SUVmax >4. SUVmax was significantly increased in tumours with monosomy 3 (p=0.043) but not in tumours with chromosome 8 gain (p=0.49). SUVmax and increasing tumour size were positively correlated (p<0.05). Using the AJCC criteria, there was a significant difference in SUVmax among prognostic groups (p=0.024). There was no correlation with histopathological cell type (p=0.923).
  
  
  CONCLUSIONS
  Metabolic activity of uveal melanoma on PET/CT scan is positively correlated with monosomy 3, increasing tumour size and TNM prognostic groups. No association with chromosome 8 gain or histopathology cell type was noted. SUVmax >4 is a relative but not an absolute indicator of monosomy 3 status.
authors.affiliation: Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK.
authors.forename: Vasilios P
authors.initials: VP
authors.lastname: Papastefanou
authors.affiliation: Department of Nuclear Medicine, St Bartholomew`s Hospital, London, UK.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of Nuclear Medicine, St Bartholomew`s Hospital, London, UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Szyszko
authors.affiliation: Department of Molecular Medicine, Royal London Hospital, London, UK.
authors.forename: Marianne
authors.initials: M
authors.lastname: Grantham
authors.affiliation: Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK UCL Institute of Ophthalmology, London, UK.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sagoo
authors.affiliation: Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK.
authors.forename: Victoria M L
authors.initials: VM
authors.lastname: Cohen
mesh_terms: D002893:Chromosomes, Human, Pair 3 / Q000235:genetics*; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics; D015353:Eye Enucleation; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics*; D009006:Monosomy / Q000235:genetics*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014604:Uveal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics*; D000098943:Uveal Melanoma
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: choroid; genetics; imaging; neoplasia; pathology
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