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State-of-the-Art Diagnosis and Treatment of Melanoma

Optimal Multidetector Computed Tomographic Practice to Identify Metastatic Disease and Review of Innovative Therapeutic Agents

Jones, Blake C., MD*; Lipson, Evan J., MD; Childers, Brandon, MD*; Fishman, Elliot K., MD*; Johnson, Pamela T., MD*

Journal of Computer Assisted Tomography: May/June 2018 - Volume 42 - Issue 3 - p 331–339
doi: 10.1097/RCT.0000000000000697
Special Review

The incidence of melanoma has risen dramatically over the past several decades. Oncologists rely on the ability of radiologists to identify subtle radiographic changes representing metastatic and recurrent melanoma in uncommon locations on multidetector computed tomography (MDCT) as the front-line imaging surveillance tool. To accomplish this goal, MDCT acquisition and display must be optimized and radiologist interpretation and search patterns must be tailored to identify the unique and often subtle metastatic lesions of melanoma. This article describes MDCT acquisition and display techniques that optimize the visibility of melanoma lesions, such as high-contrast display windows and multiplanar reconstructions. In addition, innovative therapies for melanoma, such as immunotherapy and small-molecule therapy, have altered clinical management and outcomes and have also changed the spectrum of therapeutic complications that can be detected on MDCT. Recent advances in melanoma therapy and potential complications that the radiologist can identify on MDCT are reviewed.

From *The Russell H. Morgan Department of Radiology and Radiological Science and

Division of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD.

Received for publication February 26, 2017; accepted September 25, 2017.

Correspondence to: Pamela T. Johnson, MD, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, JHOC 4223 Radiology, 600 North Wolfe St, Baltimore, MD 21287 (e-mail:

Disclosures: Elliot Fishman is on the advisory board of and has received grant funding from GE Healthcare and Siemens Medical Systems. He is a cofounder of HipGraphics, Inc. Evan Lipson is a consultant for Bristol-Myers Squibb, EMD Serono, Merck, and Novartis and receives research funding from Genentech and Merck. Blake C. Jones, Brandon Childers, and Pamela T. Johnson have no conflicts of interest.

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