99mTc-sestamibi SPECT/CT and 18F-FDG-PET/CT have similar performance but different imaging patterns in newly diagnosed multiple myeloma

Mosci, Camila; Pericole, Fernando V; Oliveira, Gislaine B.; Delamain, Márcia Torresan; Takahashi, Maria Emília Seren; Carvalheira, José Barreto Campello; Etchebehere, Elba; Santos, Allan O.; Miranda, Eliana Cristina Martins; Lima, Mariana; Amorim, Bárbara Juarez; Souza, Cármino Antônio de; Lorand‐Metze, Irene; Ramos, Celso Darío

doi:10.1097/mnm.0000000000001259

Cited by 9 publications

(7 citation statements)

References 30 publications

(32 reference statements)

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“…Several previous studies reported comparable patterns of plasma cell bone marrow infiltration on 18 F-FDG PET/CT. 19,23,24,25 Inherent limitations of this study were its retrospective nature and the heterogeneity of the study population. Potential consequences of these are the confounding effects of treatment status, haemoglobin level, HIV status and time of difference between 18 F-FDG PET/CT and BMB.…”

Section: Discussionmentioning

confidence: 99%

The relationship between bone marrow involvement on 18F-FDG PET/CT and bone marrow biopsy in patients with multiple myeloma and other plasma cell neoplasms

et al. 2022

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Background: Bone marrow biopsy (BMB) plays a crucial role in the diagnosis and assessment of treatment response in patients with multiple myeloma (MM). 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been shown to be a complimentary measure of marrow involvement in patients with Hodgkin and diffuse large B cell lymphomas. However, only limited information is available on its relationship with BMB in MM.Aim: To assess the association between bone marrow involvement on 18F-FDG PET/CT, and BMB in patients with MM and other plasma cell neoplasms.Setting: Cape Town, South Africa.Methods: Hundred and three patients undergoing 18F-FDG PET/CT and BMB were included. Plasma cell infiltration (PCI) on BMB was compared for three visual patterns of 18F-FDG bone marrow uptake (irregular, diffuse less than or equal to the liver and diffuse greater than liver).Results: Eighty-four patients had diffuse bone marrow uptake. Of these, 25/84 had uptake greater than liver, all having PCI ≥ 60% and a median value of 85%. Of the 84 patients, the 59 patients with uptake less than or equal to liver had PCI 10% in 57.6% (34/59), and ≥ 10% in 42.4% (25/59) with a median value of 8%. Nineteen patients had irregular bone marrow uptake. Of these, 4/19 (21.1%) had PCI of 10% and 15/19 (78.9%) had PCI ≥ 10%, with the median value of 23%. The median percentage of PCI across the three described patterns of FDG uptake was significantly different (p = 0.0001).Conclusion: 18F-fluorodeoxyglucose positron emission tomography/computed tomography might avoid the need of repeat BMB in most of the patients with diffuse and irregular patterns of 18F-FDG uptake.

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Section: Discussionmentioning

confidence: 99%

The relationship between bone marrow involvement on 18F-FDG PET/CT and bone marrow biopsy in patients with multiple myeloma and other plasma cell neoplasms

et al. 2022

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“…Single-photon emission computed tomography (SPECT)/CT using 99mTc-sestamibi (MIBI)-which is related to mitochondrial activity-has been demonstrated to be more efficient than FDG-PET/CT for detecting the diffuse involvement of bone marrow in MM [71]. 68Ga-labeled prostate-specific membrane antigen (PSMA) PET/CT can also detect MM lesions, probably by evidencing neoangiogenesis in the lesions [72,73] (Figure 7).…”

Section: Other Radiotracers Used For Multiple Myelomamentioning

confidence: 99%

“…It is interesting and intriguing that radiopharmaceuticals that represent such diverse metabolic aspects can identify the same disease. Generally, different tracers present different uptake intensities in different lesions of the same MM patient [71,74,75]. The entirely distinct uptake mechanisms of these radiopharmaceuticals suggest that this is related to the very heterogeneous biological behavior of this disease.…”

Section: Fdg-pet In Comparison With Mri and Ctmentioning

confidence: 99%

Metabolic Volume Measurements in Multiple Myeloma

et al. 2021

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Multiple myeloma (MM) accounts for 10–15% of all hematologic malignancies, as well as 20% of deaths related to hematologic malignant tumors, predominantly affecting bone and bone marrow. Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) is an important method to assess the tumor burden of these patients. It is often challenging to classify the extent of disease involvement in the PET scans for many of these patients because both focal and diffuse bone lesions may coexist, with varying degrees of FDG uptake. Different metrics involving volumetric parameters and texture features have been proposed to objectively assess these images. Here, we review some metabolic parameters that can be extracted from FDG-PET/CT images of MM patients, including technical aspects and predicting MM outcome impact. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters known to be independent predictors of MM outcome. However, they have not been adopted in clinical practice due to the lack of measuring standards. CT-based segmentation allows automated, and therefore reproducible, calculation of bone metabolic metrics in patients with MM, such as maximum, mean and standard deviation of the standardized uptake values (SUV) for the entire skeleton. Intensity of bone involvement (IBI) is a new parameter that also takes advantage of this approach with promising results. Other indirect parameters obtained from FDG-PET/CT images, such as visceral adipose tissue glucose uptake and subcutaneous adipose tissue radiodensity, may also be useful to evaluate the prognosis of MM patients. Furthermore, the use and quantification of new radiotracers can address different metabolic aspects of MM and may have important prognostic implications.

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“…Bone disease is also related to increased mortality. In addition, new therapies for MM are going to be developed and tested in clinical trials, where imaging techniques can be considered as a surrogate endpoint, especially in patients with early disease [ 2 , 3 , 6 , 7 , 8 , 9 , 10 ]. Alongside these developments in medical therapies, imaging tools have been showing progressive improvements over the last decades, with increased complexity.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, CT-based scoring systems could be suitable instruments for use in clinical trials if reliability is assured. Unfortunately, there is little or even no consensus yet on CT scoring systems, even with regards to the most elementary MM lesions [ 1 , 8 , 12 ]. In 2020, a preliminary CT-based scoring system, called the “ myeloma spine and bone damage score ” (MSBDS), was developed and included semi-quantitative assessments of elementary lesions using descriptive criteria with the aim of harmonizing total body CT interpretation in MM [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Myeloma Spine and Bone Damage Score (MSBDS) on Whole-Body Computed Tomography (WBCT): Multiple Reader Agreement in a Multicenter Reliability Study

et al. 2022

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Objective: To assess the reliability of the myeloma spine and bone damage score (MSBDS) across multiple readers with different levels of expertise and from different institutions. Methods: A reliability exercise, including 104 data sets of static images and complete CT examinations of patients affected by multiple myeloma (MM), was performed. A complementary imaging atlas provided detailed examples of the MSBDS scores, including low-risk and high-risk lesions. A total of 15 readers testing the MSBDS were evaluated. ICC estimates and their 95% confidence intervals were calculated based on mean rating (k = 15), absolute agreement, a two-way random-effects model and Cronbach’s alpha. Results: Overall, the ICC correlation coefficient was 0.87 (95% confidence interval: 0.79–0.92), and the Cronbach’s alpha was 0.93 (95% confidence interval: 0.94–0.97). Global inter- and intra-observer agreement among the 15 readers with scores below or equal to 6 points and scores above 6 points were 0.81 (95% C.I.: 0.72–0.86) and 0.94 (95% C.I.:0.91–0.98), respectively. Conclusion: We present a consensus-based semiquantitative scoring systems for CT in MM with a complementary CT imaging atlas including detailed examples of relevant scoring techniques. We found substantial agreement among readers with different levels of experience, thereby supporting the role of the MSBDS for possible large-scale applications. Significance and Innovations • Based on previous work and definitions of the MSBDS, we present real-life reliability data for quantitative bone damage assessment in multiple myeloma (MM) patients on CT. • In this study, reliability for the MSBDS, which was tested on 15 readers with different levels of expertise and from different institutions, was shown to be moderate to excellent. • The complementary CT imaging atlas is expected to enhance unified interpretations of the MSBDS between different professionals dealing with MM patients in their routine clinical practice.

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99mTc-sestamibi SPECT/CT and 18F-FDG-PET/CT have similar performance but different imaging patterns in newly diagnosed multiple myeloma

Cited by 9 publications

References 30 publications

The relationship between bone marrow involvement on 18F-FDG PET/CT and bone marrow biopsy in patients with multiple myeloma and other plasma cell neoplasms

The relationship between bone marrow involvement on 18F-FDG PET/CT and bone marrow biopsy in patients with multiple myeloma and other plasma cell neoplasms

Metabolic Volume Measurements in Multiple Myeloma

Myeloma Spine and Bone Damage Score (MSBDS) on Whole-Body Computed Tomography (WBCT): Multiple Reader Agreement in a Multicenter Reliability Study

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