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Imaging of abdominal manifestations of melanoma
I R Kamel1, J B Kruskal, H F Gramm
1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Abstract:
Despite an increasing incidence of melanoma in this country, innovative new therapies are allowing patients to receive aggressive experimental treatments. Diagnostic imaging remains crucial for tumor staging and for follow-up of patients being treated with these protocols. Because metastases occur in the abdomen and pelvis in approximately 60% of patients, it is important to accurately identify all sites of tumor spread. A variety of imaging techniques are used to image these patients, with CT currently being used for staging purposes and to guide diagnostic biopsies. Other imaging techniques, such as MR, ultrasound, and fluoroscopy, are currently reserved for investigating specific complications of melanoma, such as vascular invasion, hemorrhage from a tumor, and small bowel involvement, including intussusception. Recently, whole body positron emission tomography (PET) imaging using 2-deoxy-2-fluoro-D-glucose (FDG) has been shown to be highly accurate in assessing patients with metastatic malignant melanoma. This review illustrates the spectrum of manifestations of metastatic melanoma throughout the abdomen and pelvis, including solid organ, hollow lumen, and retroperitoneal involvement, and demonstrates some of the typical and atypical manifestations that may be identified.
Insights
Advanced imaging, including whole-body positron emission tomography (PET), aids in staging and monitoring metastatic melanoma. This is crucial for aggressive treatments, especially given abdominal and pelvic spread in 60% of patients.
Area of Science:
- Medical imaging
- Oncology
- Radiology
Background:
- Melanoma incidence is rising, necessitating aggressive experimental treatments.
- Accurate staging and follow-up are vital for patients undergoing these therapies.
- Abdominal and pelvic metastases occur in approximately 60% of melanoma patients.
Purpose of the Study:
- To review the imaging manifestations of metastatic melanoma in the abdomen and pelvis.
- To highlight the role of various diagnostic imaging techniques.
- To emphasize the accuracy of whole-body FDG-PET in assessing metastatic melanoma.
Main Methods:
- Review of imaging techniques including CT, MR, ultrasound, fluoroscopy, and whole-body FDG-PET.
- Illustration of typical and atypical presentations of metastatic melanoma.
- Focus on abdominal and pelvic involvement: solid organ, hollow lumen, and retroperitoneal.
Main Results:
- CT is used for staging and biopsy guidance.
- MR, ultrasound, and fluoroscopy are used for specific complications.
- Whole-body FDG-PET demonstrates high accuracy in assessing metastatic melanoma.
Conclusions:
- Accurate identification of abdominal and pelvic metastases is critical for melanoma patient management.
- Whole-body FDG-PET is a highly accurate tool for staging and follow-up.
- Understanding the spectrum of imaging findings is essential for effective diagnosis and treatment planning.