Clinical and Imaging Follow-Up for High-Risk Cutaneous Melanoma: Current Evidence and Guidelines

Area of Science:

• Oncology
• Radiology
• Dermatology

Background:

• The American Joint Committee on Cancer (AJCC) staging system categorizes invasive cutaneous melanoma into low-risk (stage IA-IIA) and high-risk (stage IIB-IV) groups.
• Surveillance imaging for high-risk melanoma patients lacks uniform recommendations due to limited, varied data, despite its intuitive benefit.

Purpose of the Study:

• To review the current evidence and recommendations for surveillance imaging in high-risk melanoma patients.
• To highlight the role of imaging in the context of effective systemic therapies (ESTs).

Main Methods:

• Review of retrospective and prospective data on melanoma surveillance imaging.
• Analysis of current guidelines and expert opinions on follow-up strategies.
• Consideration of imaging modalities like PET, CT, and MRI.

Main Results:

• The majority of data support the use of imaging for high-risk melanoma follow-up.
• Positron emission tomography (PET) or whole-body computerized tomography (CT) are considered reasonable follow-up options.
• Brain magnetic resonance imaging (MRI) is recommended for detecting brain metastases when feasible.

Conclusions:

• Imaging plays a crucial role in monitoring response to effective systemic therapies (ESTs) and detecting relapse in high-risk melanoma.
• Standardization of imaging protocols is needed, but current evidence supports its use in high-risk cases.