To investigate the value of18F-FDG-PET/CT in predicting the occurrence of brain metastases in melanoma patients, in this retrospective study 201 consecutive patients with pathology-proven melanoma, between 2008 and 2021, were reviewed. Those who underwent18F-FDG-PET/CT for initial staging were considered eligible. Baseline assessment included histopathology,18F-FDG-PET/CT, and brain MRI. Also, all patients had serial follow-ups for diagnosing brain metastasis development. Baseline18F-FDG-PET/CT parameters were analysed using competing risk regression models to analyze their correlation with the occurrence of brain metastases. Overall, 159 patients entered the study. The median follow-up was six years. Among clinical variables, the initial M-stage and TNM-stage were significantly correlated with brain metastasis. Regarding18F-FDG-PET/CT parameters, regional metastatic lymph node uptake values, as well as prominent SULmax (pSULmax) and prominent SUVmean (pSUVmean), were significantly correlated with the outcome. Cumulative incidences were 10% (6.3–16%), 31% (24.4–38.9%), and 35.2% (28.5–43.5%) after 1, 5, and 10 years. There were significant correlations between pSULmax (p-value < 0.001) and pSULpeak (p-value < 0.001) and the occurrence of brain metastases. The higher these values, the sooner the patient developed brain metastases. Thus, baseline18F-FDG-PET/CT may have the potential to predict brain metastasis in melanoma patients. Those with high total metabolic activity should undergo follow-up/complementary evaluations, such as brain MRI.
为探讨¹⁸F-FDG-PET/CT对黑色素瘤患者脑转移发生的预测价值，本研究回顾性分析了2008年至2021年间经病理证实的201例连续黑色素瘤患者。将接受¹⁸F-FDG-PET/CT进行初始分期的患者纳入研究范围。基线评估包括组织病理学、¹⁸F-FDG-PET/CT及脑部MRI检查。所有患者均接受系列随访以诊断脑转移发生情况。采用竞争风险回归模型分析基线¹⁸F-FDG-PET/CT参数与脑转移发生的相关性。最终共159例患者纳入研究，中位随访时间为六年。临床变量中，初始M分期与TNM分期与脑转移显著相关。在¹⁸F-FDG-PET/CT参数方面，区域转移性淋巴结摄取值、显著最大标准化摄取值（pSULmax）及显著平均标准化摄取值（pSUVmean）与脑转移发生显著相关。1年、5年及10年累积发生率分别为10%（6.3–16%）、31%（24.4–38.9%）和35.2%（28.5–43.5%）。pSULmax（p值<0.001）和pSULpeak（p值<0.001）与脑转移发生存在显著相关性，且数值越高患者发生脑转移的时间越早。因此，基线¹⁸F-FDG-PET/CT可能具有预测黑色素瘤患者脑转移的潜力，对于高代谢活性的患者应进行脑部MRI等随访/补充评估。
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