A First Report on [¹⁸F]FPRGD₂ PET/CT Imaging in Multiple Myeloma

Abstract

An observational study was set up to assess the feasibility of [18F]FPRGD2 PET/CT for imaging patients with multiple myeloma (MM) and to compare its detection rate with low dose CT alone and combined [18F]NaF/[18F]FDG PET/CT images. Four patients (2 newly diagnosed patients and 2 with relapsed MM) were included and underwent whole-body PET/CT after injection of [18F]FPRGD2. The obtained images were compared with results of low dose CT and already available results of a combined [18F]NaF/[18F]FDG PET/CT. In total, 81 focal lesions (FLs) were detected with PET/CT and an underlying bone destruction or fracture was seen in 72 (89%) or 8 (10%) FLs, respectively. Fewer FLs (54%) were detected by [18F]FPRGD2 PET/CT compared to low dose CT (98%) or [18F]NaF/[18F]FDG PET/CT (70%) and all FLs detected with [18F]FPRGD2 PET were associated with an underlying bone lesion. In one newly diagnosed patient, more [18F]FPRGD2 positive lesions were seen than [18F]NaF/[18F]FDG positive lesions. This study suggests that [18F]FPRGD2 PET/CT might be less useful for the detection of myeloma lesions in patients with advanced disease as all FLs with [18F]FPRGD2 uptake were already detected with CT alone.

Recent developments on the application of molecular probes in multiple myeloma: Beyond [18F]FDG

“…However, in relapsed MM patients, [ 18 F]FPRGD2 PET/CT is not particularly helpful and was dependent on the presence of obvious lytic bone lesions found by CT (listed in Table 2). (Withofs et al, 2017) 1-α-D:-(5-deoxy-5-18 F-fluoroarabinofuranosyl)-2nitroimidazole ([ 18 F]FAZA) is a PET tracer used to identify hypoxic conditions associated with tumor metabolism (Wuest and Wuest, 2013). When cells are oxygen-deficient, nitroimidazole reduction products will bind to intracellular biomacromolecules and remain in cells.…”