Response to Therapy

The usefulness of FDG-PET in evaluating response to therapy was shown by Mercier et al.,376 who studied three patients who underwent a FDG-PET scan before and 1 month after treatment (isolated limb perfusion therapy with melphalan) and found a reduction in the number of lesions and diffuse radiotracer uptake, most likely because of posttreatment inflammation.

11 C-Methionine,379 125I-alpha-methyl-tyrosine (AMT), 18F-DOPA,380 18F-FLT,381 11C-N-methylspiperone,382 and radiolabeled alpha-melanocyte-stimulating hormone383 are some of the new promising radiopharamaceuticals in the field of melanoma.

In conclusion, FDG-PET is the modality of choice for evaluating patients who fit in one of these four categories:

1. Individuals at high risk for distant metastases based on the extent of locoregional disease

2. Patients with findings that are suspicious for distant metastases

3. Individuals with known distant tumor deposits who still stand to benefit from customized therapies if new lesions are discovered or treated lesions regress

4. Patients at high risk for systemic relapse who are considering aggressive medical therapy

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