Background/Objectives: Electrochemotherapy (ECT) has emerged as a promising locoregional treatment modality for patients with cutaneous and subcutaneous melanoma metastases. While systemic therapies have improved overall disease control, effective local tumor management remains crucial, particularly in oligometastatic or symptomatic disease. This pilot study investigates the role of metabolic imaging with [18F]FDG PET/CT to assess tumor metabolism in melanoma patients undergoing ECT, building on prior evidence that PET offers valuable functional information beyond anatomical changes detected by conventional imaging.Methods: This retrospective study included 11 patients with histologically confirmed melanoma and cutaneous or subcutaneous metastases treated with ECT. [18F]FDG PET/CT scans were performed either before ECT, after ECT, or both. Metabolic response was assessed by measuring the tracer uptake (SUVmax) of the ten hottest lesions. Morphological changes were evaluated using CT. Local progression-free survival was determined.Results: A total of 66 lesions were analyzed. Patients with PET/CT only after ECT showed significantly higher SUVmaxand lesion size compared to those imaged before treatment (mean SUVmax: 9.9 ± 11.2 vs. 10.3 ± 5.5;p= 0.034). Progression-free survival differed significantly based on pre-ECT SUVmaxvalues (χ2= 3.90;p= 0.048). Among two patients with follow-up imaging, one showed new lesions on CT with only mild FDG uptake, while the other developed newly FDG-avid metastases after ECT.Conclusions: FDG PET/CT provides valuable information on tumor viability and treatment response in melanoma patients undergoing ECT, demonstrated by significant differences in metabolic activity between lesions imaged before and after treatment. The lack of longitudinal intra-individual imaging limits definitive conclusions about the direct metabolic effects of ECT.
背景/目的：电化学疗法已成为治疗皮肤及皮下黑色素瘤转移灶的一种前景广阔的局部区域治疗手段。虽然全身性治疗改善了整体疾病控制，但有效的局部肿瘤管理仍然至关重要，尤其在寡转移或有症状的疾病中。基于正电子发射断层扫描能提供超越传统影像学解剖结构变化的功能性信息这一前期证据，本项初步研究探讨了[18F]FDG PET/CT代谢显像在评估接受电化学疗法治疗的黑色素瘤患者肿瘤代谢中的作用。 方法：这项回顾性研究纳入了11例经组织学确诊为黑色素瘤并接受电化学疗法治疗的皮肤或皮下转移患者。患者在电化学疗法治疗前、治疗后或两个时间点均接受了[18F]FDG PET/CT扫描。通过测量十个最活跃病灶的示踪剂摄取量（最大标准化摄取值）来评估代谢反应。使用CT评估形态学变化。并确定了局部无进展生存期。 结果：共分析了66个病灶。与治疗前进行影像学检查的患者相比，仅在电化学疗法治疗后接受PET/CT检查的患者显示出显著更高的最大标准化摄取值和病灶大小（平均最大标准化摄取值：9.9 ± 11.2 对比 10.3 ± 5.5；p=0.034）。基于电化学疗法治疗前的最大标准化摄取值，无进展生存期存在显著差异（χ2=3.90；p=0.048）。在两名接受随访影像学检查的患者中，一例在CT上显示新病灶但仅伴有轻度FDG摄取，而另一例在电化学疗法治疗后出现了新的FDG高摄取转移灶。 结论：FDG PET/CT为接受电化学疗法治疗的黑色素瘤患者提供了关于肿瘤活性和治疗反应的重要信息，这通过治疗前后成像病灶代谢活性的显著差异得以证明。缺乏纵向个体内影像学数据限制了对电化学疗法直接代谢效应得出明确结论。
肿瘤(癌症)患者之家