Imaging of Merkel Cell Carcinoma

Imaging findings characteristic of Merkel cell carcinoma are highlighted as well as the significance of CT, MRI, sentinel lymph node mapping, <sup>18</sup>F-FDG PET/CT, and other nuclear medicine studies.

Course ID: Q00623 Category:
Modalities: , , , ,


Satisfaction Guarantee


Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.50
Procedures: 1.50
Head, Spine, and Musculoskeletal: 0.50
Neck and Chest: 0.50
Abdomen and Pelvis: 0.50

Magnetic Resonance Imaging: 1.50
Procedures: 1.50
Neurological: 0.50
Body: 0.50
Musculoskeletal: 0.50

Nuclear Medicine Technology: 2.00
Procedures: 2.00
Endocrine and Oncology Procedures: 1.00
Other Imaging Procedures: 1.00

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Abdominal Section: 0.50
Thoracic Section: 0.50
Musculoskeletal and Endocrine Sections: 0.50
Neurological, Vascular, and Lymphatic Sections: 0.50

Sonography: 1.50
Procedures: 1.50
Superficial Structures and Other Sonographic Procedures: 1.50

Radiation Therapy: 2.00
Patient Care: 0.50
Patient and Medical Record Management: 0.50
Procedures: 1.50
Treatment Sites and Tumors: 1.00
Treatments: 0.50


  1. Introduction
  2. Clinical Features
  3. Causative Factors
  4. MCPyV Serology Test
  5. Staging and Prognosis
  6. Role of Imaging
    1. Imaging of Primary or Regional MCC
    2. Sentinel Lymph Node Biopsy
    3. Detecting Nodal or Distant Metastasis
  7. Treatment
  8. Follow-up or Assessment of Treatment Response
  9. Role of Specific Nuclear Medicine Studies
    1. 18F-FDG PET
    2. Bone Scintigraphy
    3. Somatostatin Receptor-Seeking Nuclear Medicine
    4. 18F-FDG PET versus 68Ga-Somatostatin Analog PET
  10. Peptide Receptor Radionuclide Therapy
  11. Conclusion


Upon completion of this course, students will:

  1. be familiar with percentage of MCC patients with nodal or distant metastasis at initial presentation
  2. identify the SSRT types for which MCC has a higher affinity
  3. recognize the typical clinical feature of MCC nodules
  4. be familiar with the significant features of MCC
  5. be familiar with the serology test used for evaluation of MCC patients
  6. be familiar with the clinical practice guidelines of the NCCN
  7. be familiar with the stages of the AJCC TNM staging system
  8. identify the most reliable staging tool for identifying subclinical nodal MCC disease
  9. be familiar with the estimated 5-year overall survival for MCC patients with local MCC disease
  10. identify the imaging modality that enables real-time imaging possible with simultaneous fine-needle or core needle biopsy
  11. be familiar with the reported mean maximum SUV at 18F-FDG PET for primary MCC
  12. be familiar with the sensitivity of SLNB in Stage I and II MCC
  13. be familiar with the administration of 99mTc sulfur colloid for sentinel lymph node mapping
  14. identify the imaging modality used to localize sentinel lymph nodes in anatomically complex areas during lymphoscintigraphy
  15. recognize the imaging modalities that may be used at MCC metastasis
  16. identify the imaging modality that is increasingly being used for detection of distant MCC metastasis
  17. identify which imaging modality should be used for brain metastasis in MCC patients
  18. be familiar with the standard treatment options for MCC patients
  19. be familiar with the preferable treatment for MCC patients with distant metastasis
  20. identify the immunotherapy agents used for systemic therapy of MCC patients
  21. be familiar with the imaging criteria for MCC patients receiving immunotherapy
  22. identify the imaging modality that has significantly influenced treatment decisions and management of MCC patients
  23. identify the radiopharmaceutical used to perform bone scintigraphy in MCC patients
  24. be familiar with the flare phenomenon in bone scintigraphy
  25. identify the radiopharmaceuticals that can be linked to peptides that bind to SSTR
  26. be familiar with the advantages of 68GA-DOTATATE vs. 111In-pentetreotide for imaging patients with NETs
  27. be familiar with the preparation time for imaging a patient with 68GA-labeled somatostatin
  28. identify the only PET radiotracer indicated for MCC in the NCCN guidelines
  29. be familiar with the guidelines for tumor grading based on ENETS
  30. identify the radioisotopes used for therapeutic treatment of MCC