Positron Emission Tomography/Computed Tomography Transformation Oncology Melanoma and Skin Malignancies

PET imaging has an important role in the management of the most common cutaneous malignancies. FDG PET is not typically used in the characterization of the primary lesion, but for assessing for distant metastatic disease, particularly those with late stage or advanced disease. In the era of increasing immunotherapies and small molecule inhibitors in the treatment of metastatic melanoma, FDG-PET/CT has increasing use in assessment of treatment response over conventional imaging, and prognostication. A good understanding of immune modulation effects on FDG-PET is important to accurately interpret PET scans in these setting. In restaging, PET may be indicated where there are suspicious clinical symptoms, in -transit disease or palpable lymphadenopathy, or other suggestions of possible locoregional or metastatic disease. PET clearly impacts on patient management and can guide treatment decisions. Although there is controversy over the role of PET in surveillance, the sensitivity of FDG PET/CT makes it valuable in patients with high -risk disease. The use of new PET tracers and advanced PET technology may assist in more accurate staging of disease in the future and assist in developing biologic therapies targeted to specific oncogenic pathways in melanomas.