Value of Precise Localization of Recurrent Multiple Myeloma With F-18 FDG PET/CT

Abstract

A 37-year-old man with multiple myeloma in remission underwent routine fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) study for disease restaging. Both FDG-PET and CT images showed focal abnormalities in the region of the T6 vertebra, but the fused images that are routinely provided with PET/CT could precisely localize the FDG active lesion to a soft tissue focus in the epidural space, away from a lytic nonactive vertebral body lesion despite their close proximity. The PET/CT scan identified a few other metabolically active osseous lesions out of many lytic bony changes throughout the skeleton. Accordingly, the patient received the correct management for an impending spinal cord compression at the appropriate time, in addition to systemic therapy for disease relapse.

Incidental finding of an 11C-acetate PET-positive multiple myeloma

“…18 F-FDG PET is useful for assessing the extent of active disease and treatment follow-up [2,4]. Cholewinski et al [5] reported a case of recurrent multiple myeloma diagnosed with 18 F-FDG PET. A previous report has shown that 11 C-choline PET was more sensitive than 18 F-FDG PET for detecting bone involvement [6].…”