Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

The Value of Technetium-99m Labeled Alpha-Melanocyte- Stimulating Hormone (99mTc-α-MSH) in Diagnosis of Primary and Metastatic Lesions of Malignant Melanoma

Document Type : Original Article

Authors
Saeed Farzanefar 1
Rahman Etemadi 2
Mohammad Shirkhoda 3
Habibollah Mahmoodzadeh 3
Mostafa Erfani 4
Babak Fallahi 2
Mehrshad Abbasi 1
Narjess Ayati 5
Arman Hassanzadeh-Rad 2
Mohammad Eftekhari 2
Davood Beiki 2
1 Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of General Surgery, Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Radiation Application Research School, Nuclear Science and Technology Research Institute, Tehran, Iran
5 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/aojnmb.2018.30101.1204
Abstract
Objective(s): Malignant melanoma is the most lethal type of skin cancers with unfavorable prognosis. Alpha-MSH peptide analogues have a high affinity for melanocortine-1 (MC1) receptors on melanocytes over
expressing in malignant melanoma cells. Pre-clinical studies have shown promising results for radiolabeled MSH imaging in this malignancy. The purpose of this study is to assess the diagnostic value of 99mTc-α-MSH
imaging in malignant melanoma.
Methods: Twenty-one patients (13 men) with pathologically confirmed malignant melanoma with or without metastatic distribution were included in this study. 740-1110 MBq 99mTc-α-MSH was injected and whole body scans were performed 20, 120 and 240 minutes post injection and were assessed both qualitatively and semi-quantitatively using target (T) to background (BG) ratio.
Results: The T/BG ratio for the primary tumor bed was 2.51±2.26, 2.56±2.48 and 1.92±1.79 minutes in the whole body scans 20, 120 and 240 minutes post injection, respectively. The sensitivity, specificity, negative
and positive predictive values were 75%, 80%, 50% and 92% for primary lesion and 25%, 100%, 68% and 100% for distant metastasis, respectively.
Conclusion: 99mTc-α-MSH is a newly introduced agent for diagnosis of tumoral lesions in malignant melanoma. Our study showed a high sensitivity with this modality in primary lesions as well as lymph node
involvements. However the detection rate was not high in distant metastasis. The preliminary results are promising especially as a new complementary imaging method in management of malignant melanoma.
Keywords
Malignant melanoma
99mTc-α-MSH
Melanocortine-1 receptor
Melanocyte stimulating hormone
Radiolabeled peptide
Subjects
  1. Erdei E, Torres SM. A new understanding in the epidemiology of melanoma. Expert Rev Anticancer Ther. 2010;10(11):1811-23.
  2. Bandarchi B, Ma L, Navab R, Seth A, Rasty G. From melanocyte to metastatic malignant melanoma. Dermatol Res Pract. 2010;2010:583748.
  3. Sandru A, Voinea S, Panaitescu E, Blidaru A. Survival rates of patients with metastatic malignant melanoma. J Med Life. 2014;7(4):572-6.
  4. Singnurkar A, Wang J, Joshua AM, Langer DL, Metser U. 18F-FDG-PET/CT in the staging and management of melanoma: a prospective multicenter ontario PET registry study. Clin Nucl Med. 2016;41(3):189-93.
  5. Dimitrakopoulou-Strauss A, Strauss LG, Burger C. Quantitative PET studies in pretreated melanoma patients: a comparison of 6-[18F]fluoro-L-dopa with 18F-FDG and (15)O-water using compartment and noncompartment analysis. J Nucl Med. 2001;42(2):248-56.
  6. Liu L, Xu J, Yang J, Feng C, Miao Y. Imaging human melanoma using a novel Tc-99m-labeled lactam bridge-cyclized alpha-MSH peptide. Bioorg Med Chem Lett. 2016;26(19):4724-8.
  7. Shamshirian D, Erfani M, Beiki D, Fallahi B, Shafiei M. Development of a (99m)Tc-labeled lactam bridge-cyclized alpha-MSH derivative peptide as a possible single photon imaging agent for melanoma tumors. Ann Nucl Med. 2015;29(8):709-20.
  8. Miao Y, Benwell K, Quinn TP. 99mTc- and 111In-labeled alpha-melanocyte-stimulating hormone peptides as imaging probes for primary and pulmonary metastatic melanoma detection. J Nucl Med. 2007;48(1):73-80.
  9. Guo H, Miao Y. Cu-64-labeled lactam bridge-cyclized α-MSH peptides for PET imaging of melanoma. Mol Pharm. 2012;9(8):2322-30.

10. Guo H, Yang J, Gallazzi F, Miao Y. Effects of the amino acid linkers on the melanoma-targeting and pharmacokinetic properties of 111In-labeled lactam bridge-cyclized alpha-MSH peptides. J Nucl Med. 2011;52(4):608-16.

11. Guo H, Gallazzi F, Miao Y. Gallium-67-labeled lactam bridge-cyclized alpha-MSH peptides with enhanced melanoma uptake and reduced renal uptake. Bioconjug Chem. 2012;23(6):1341-8.

12. Guo H, Miao Y. Melanoma targeting property of a Lu-177-labeled lactam bridge-cyclized alpha-MSH peptide. Bioorg Med Chem Lett. 2013;23(8):2319-23.

13. Guo H, Miao Y. Introduction of an 8-aminooctanoic acid linker enhances uptake of 99mTc-labeled lactam bridge-cyclized α-MSH peptide in melanoma. J Nucl Med. 2014;55(12):2057-63.

14. Liu L, Xu J, Yang J, Feng C, Miao Y. Metastatic melanoma imaging using a novel Tc-99m-labeled lactam-cyclized alpha-MSH peptide. Bioorg Med Chem Lett. 2017;27(22):4952-5.

15. Vreugdenburg TD, Ma N, Duncan JK, Riitano D, Cameron AL, Maddern GJ. Comparative diagnostic accuracy of hepatocyte-specific gadoxetic acid (Gd-EOB-DTPA) enhanced MR imaging and contrast enhanced CT for the detection of liver metastases: a systematic review and meta-analysis. Int J Colorectal Dis. 2016;31(11):1739-49.

16. Krug B, Dietlein M, Groth W, Stützer H, Psaras T, Gossmann A, et al. Fluor-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in malignant melanoma. Diagnostic comparison with conventional imaging methods. Acta Radiol. 2000;41(5):446-52.

17. Holder WD Jr, White RL Jr, Zuger JH, Easton EJ Jr, Greene FL. Effectiveness of positron emission tomography for the detection of melanoma metastases. Ann Surg. 1998;227(5):764-9.

Asia Oceania Journal of Nuclear Medicine and Biology
Volume 6, Issue 2
July 2018
Pages 155-160