| Summary: | Aim: To perform a comprehensive analysis of discordances between contrast-enhanced CT (ceCT) and <sup>18</sup>F-FDG PET/CT in the evaluation of the extra-cerebral treatment monitoring in patients with stage IV melanoma. Materials and methods: We conducted a retrospective monocentric observational study over a 3-year period in patients referred for <sup>18</sup>F-FDG PET/CT and ceCT in the framework of therapy monitoring of immune checkpoint (ICIs) as of January 2017. Imaging reports were analyzed by two physicians in consensus. The anatomical site responsible for discordances, as well as induced changes in treatment were noted. Results: Eighty patients were included and 195 pairs of scans analyzed. Overall, discordances occurred in 65 cases (33%). Eighty percent of the discordances (52/65) were due to <sup>18</sup>F-FDG PET/CT scans upstaging the patient. Amongst these discordances, 17/52 (33%) led to change in patient’s management, the most frequent being radiotherapy of a progressing site. ceCT represented 13/65 (20%) of discordances and induced changes in patients’ management in 2/13 cases (15%). The most frequent anatomical site involved was subcutaneous for <sup>18</sup>F-FDG PET/CT findings and lung or liver for ceCT. Conclusions: Treatment monitoring with <sup>18</sup>F-FDG PET/CT is more efficient than ceCT and has a greater impact in patient’s management.
|
|---|
