Positive Correlation between Baseline PET or PET/CT Findings and Clinical Parameters in Multiple Myeloma Patients

Abstract

Recently, positron emission tomography (PET) has been incorporated into a series of prospective studies as a predictor of outcomes in multiple myeloma (MM), and the number of ¹⁸F-fluorodeoxuglucose (FDG)-avid focal lesions (FLs) and the intensity of tumor metabolism have been designated as important surrogate markers for predicting prognosis. Here, we compared initial clinical characteristics of MM patients with baseline PET parameters: the number of FLs and the maximum standardized uptake value (SUV_max). A total of 59 patients diagnosed with MM between August 2004 and February 2012 were reviewed. At diagnosis, 23 patients (40.0%) had ≤3 FLs, 11 patients (18.6%) 4-9 FLs, and 25 patients (42.4%) ≥10 FLs. The median SUV_max was 5.3 (range 0-24.3), and 40 patients (67.8%) showed a SUV_max >4. No clinical characteristics were significantly different between groups with a SUV_max ≤4 and a SUV_max >4. However, there were significant differences in several clinical indices between the FLs ≤3 and FLs >3 groups; elevated β₂-microglobulin, elevated lactate dehydrogenase, anemia and more advanced disease by the Durie-Salmon stage corresponded to FLs >3 at baseline PET. Adverse baseline PET findings are positively correlated with prognostically relevant clinical parameters. Regarding PET parameters, FLs are more likely to be well correlated with disease aggressiveness and pathophysiology compared to SUV_max.

PET/CT Improves the Definition of Complete Response and Allows to Detect Otherwise Unidentifiable Skeletal Progression in Multiple Myeloma

“…Imaging features have likewise been combined and correlated with a series of established prognostic variables, such as b2M, CRP, albumin, LDH, and genetic abnormalities (2,4). Patients with more than 3 FLs on FDG PET/CT at diagnosis were reported to have significantly higher LDH and b2M values, more severe anemia, and to be more frequently in advanced stages of the disease (19). A diffuse pattern of bone marrow involvement on MRI was found to be associated with high-risk cytogenetics (4).…”

Is there any complimentary role of F-18 NaF PET/CT in detecting of osseous involvement of multiple myeloma? A comparative study for F-18 FDG PET/CT and F-18 FDG NaF PET/CT

“…Positron emission tomography (PET)/computed tomography (CT) with fluorine-18 fluorodeoxyglucose (FDG) imaging combines whole-body functional imaging with PET and morphologic imaging with CT in a single study that provides functional information about the rate of glucose metabolism in the body. The basic concept in its application in MM is that malignant plasma cells, that infiltrate the bone marrow, consume much more glucose than normal cells [9][10][11][12]. Many studies [13][14][15] consistently emphasized that F-18 FDG imaging was an accurate and dependable technique in detecting MM osteolytic lesions in a higher number of patients and with greater sensitivity and specificity compared with routinely performed radiographs, bone scan, and CT or MRI.…”

Predictive value of 18F‐FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma

“…3 Although the criteria of these parameters varied in different studies, most of the studies showed similar trends such that these parameters may serve as potential prognostic factors in MM. 9 However, FDG is not a MM tumor cell-specific agent, false-positive findings may appear in some benign tumors, inflammatory foci or normal organs. 10 Thus, the best way to probe the value of PET/CT in MM is to combine it with other MM tumor cell-specific markers.…”