[¹⁸F]FDG PET/CT in mucosal melanoma lesional metabolic activity predicts progression.

Abstract

This study investigates the prognostic value of [¹⁸F]FDG PET/CT-derived parameters in predicting PFS and OS in mucosal melanoma patients. This single-center retrospective study included 58 patients with primary mucosal melanoma who underwent [¹⁸F]FDG PET/CT imaging. PET/CT parameters (SUVmax, SUVr, WBMTV, WBTLG) were extracted from delineated lesions. Kaplan-Meier curves, ROC analysis, and univariate and multivariate Cox regression were used to assess predictive performance and identify prognostic factors for PFS and OS. The median follow-up was 15 months (range: 1-48 months). Disease progression occurred in 47 patients (median PFS = 8.0 months, 95% CI: 7.0-11.0 months), and 30 patients died (median OS = 18.0 months, 95% CI: 15.0 months - NE). ROC analysis showed all [¹⁸F]FDG PET/CT parameters (SUVmax, SUVr, WBMTV and WBTLG) could predicted progression and mortality (all p < 0.01). The optimal cutoff value of SUVmax for predicting disease progression was 10.8 g/ml; the optimal cutoff value of WBMTV for predicting mortality was 14.1 cm³. In univariate COX analysis, SUVmax and SUVr were significantly linked to both PFS and OS (both p < 0.05), while WBMTV and WBTLG only correlated with OS (both p < 0.01). Multivariate analysis identified SUVmax as an independent predictor of PFS (HR = 1.04, p < 0.05) and WBMTV as an independent predictor of OS (HR = 2.15, p < 0.05). [¹⁸F]FDG PET/CT parameters can aid in risk stratification and treatment decisions for mucosal melanoma. SUVmax predicts disease progression, while WBMTV forecasts overall survival.