Extended field imaging in 2-[18F]FDG PET/CT in multiple myeloma

Document Type : Original Article

Authors

1 Department of Nuclear Medicine, Faculty of Medicine, Mersin University, Mersin, Turkey

2 Department of Hematology, Faculty of Medicine, Mersin University, Mersin, Turkey

Abstract

Introduction: Previous studies suggested the prognostic significance of the number of involvement sites in 2-[18F]FDG PET/CT imaging in multiple myeloma. The aim of this study was to evaluate the significance of the findings that might be observed in case of whole body (extended field) imaging in the 2-[18F]FDG PET/CT in multiple myeloma patients.
Methods: The imaging findings of 70 patients (33 female, 37 male; mean 66.3±10.2 years old) with the diagnosis of multiple myeloma 2-[18F]FDG PET/CT were evaluated retrospectively. The patients were divided into two groups; Group 1; the patients with pathologic findings (lytic lesions with maximum standardized uptake value of >4) in extended field imaging and Group 2; the others respectively.
Results: The comparison of the two groups revealed no statistical significant difference between their index lesions uptake values (P>0.01). The time to progression of the groups were not significantly different (p=0.08) in the mean 27.2±32.5 months follow up. However, the ratio of disease specific mortality was higher (33% vs 5%) in the group of patients with extended field imaging findings.
Conclusion: Extended field imaging might point out higher disease specific mortality but this issue has to be evaluated by further studies in larger series.

Keywords

Main Subjects

References

  1. Mosebach J, Thierjung H, Schlemmer HP, Delorme S. Multiple myeloma guidelines and their recent updates: implications for imaging. Rofo. 2019 Nov;191(11):998-1009.
  2. Gómez León N, Aguado Bueno B, Herreros Pérez M, León Ramírez LF, Alegre A, Colletti PM, Rubello D, Carreras JL, Delgado Bolton RC. Agreement between 18F-FDG PET/CT and whole-body magnetic resonance compared with skeletal survey for initial staging and response at end-of-treatment evaluation of patients with multiple myeloma. Clin Nucl Med. 2021 Apr 1;46(4):310-22.
  3. Terao T, Machida Y, Tateishi U, Tsushima T, Narita K, Ikeda D, Fukumoto A, Kuzume A, Tabata R, Miura D, Takeuchi M, Matsue K. Association of loss of spleen visualization on whole-body diffusion-weighted imaging with prognosis and tumor burden in patients with multiple myeloma. Sci Rep. 2021 Dec 14;11(1):23978.
  4. Westerland O, Amlani A, Kelly-Morland C, Fraczek M, Bailey K, Gleeson M, El-Najjar I, Streetly M, Bassett P, Cook GJR, Goh V; Myeloma Imaging Research Group at Guy’s & St Thomas’ Hospital, London and King’s College London. Comparison of the diagnostic performance and impact on management of 18F-FDG PET/CT and whole-body MRI in multiple myeloma. Eur J Nucl Med Mol Imaging. 2021 Jul;48(8):2558-65.
  5. Mulé S, Reizine E, Blanc-Durand P, Baranes L, Zerbib P, Burns R, Nouri R, Itti E, Luciani A. Whole-body functional MRI and PET/MRI in multiple myeloma. Cancers (Basel). 2020 Oct 27;12(11):3155.
  6. Walker R, Barlogie B, Haessler J, Tricot G, Anaissie E, Shaughnessy JD Jr, Epstein J, van Hemert R, Erdem E, Hoering A, Crowley J, Ferris E, Hollmig K, van Rhee F, Zangari M, Pineda-Roman M, Mohiuddin A, Yaccoby S, Sawyer J, Angtuaco EJ. Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. J Clin Oncol. 2007 Mar 20;25(9):1121-8.
  7. Walker RC, Brown TL, Jones-Jackson LB, De Blanche L, Bartel T. Imaging of multiple myeloma and related plasma cell dyscrasias. J Nucl Med. 2012 Jul;53(7):1091-101.
  8. Derlin T, Peldschus K, Münster S, Bannas P, Herrmann J, Stübig T, Habermann CR, Adam G, Kröger N, Weber C. Comparative diagnostic performance of ¹⁸F-FDG PET/CT versus whole-body MRI for determination of remission status in multiple myeloma after stem cell transplantation. Eur Radiol. 2013 Feb;23(2):570-8.
  9. Nanni C, Zamagni E. Therapy assessment in multiple myeloma with PET. Eur J Nucl Med Mol Imaging. 2017 Aug;44(Suppl 1):111-17.
  10. Lecouvet FE, Vekemans MC, Van Den Berghe T, Verstraete K, Kirchgesner T, Acid S, Malghem J, Wuts J, Hillengass J, Vandecaveye V, Jamar F, Gheysens O, Vande Berg BC. Imaging of treatment response and minimal residual disease in multiple myeloma: state of the art WB-MRI and PET/CT. Skeletal Radiol. 2022 Jan;51(1):59-80.
  11. Lecouvet FE, Boyadzhiev D, Collette L, Berckmans M, Michoux N, Triqueneaux P, Pasoglou V, Jamar F, Vekemans MC. MRI versus 18F-FDG-PET/CT for detecting bone marrow involvement in multiple myeloma: diagnostic performance and clinical relevance. Eur Radiol. 2020 Apr;30(4):1927-37.
  12. Messiou C, Porta N, Sharma B, Levine D, Koh DM, Boyd K, Pawlyn C, Riddell A, Downey K, Croft J, Morgan V, Stern S, Cheung B, Kyriakou C, Kaczmarek P, Winfield J, Blackledge M, Oyen WJG, Kaiser MF. Prospective evaluation of whole-body MRI versus FDG PET/CT for lesion detection in participants with myeloma. Radiol Imaging Cancer. 2021 Sep;3(5):e210048.
  13. Fouquet G, Wartski M, Dechmi A, Willems L, Deau-Fischer B, Franchi P, Descroocq J, Deschamps P, Blanc-Autran E, Clerc J, Bouscary D, Barreau S, Chapuis N, Vignon M, Cottereau AS. Prognostic value of FDG-PET/CT parameters in patients with relapse/refractory multiple myeloma before Anti-CD38 based therapy. Cancers (Basel). 2021 Aug 27;13(17):4323.
  14. Jamet B, Bailly C, Carlier T, Planche L, Touzeau C, Kraeber-Bodéré F, Moreau P, Bodet-Milin C. Added prognostic value of FDG-PET/CT in relapsing multiple myeloma patients. Leuk Lymphoma. 2019 Jan;60(1):222-5.
  15. Lapa C, Lückerath K, Malzahn U, Samnick S, Einsele H, Buck AK, Herrmann K, Knop S. 18 FDG-PET/CT for prognostic stratification of patients with multiple myeloma relapse after stem cell transplantation. Oncotarget. 2014 Sep 15;5(17):7381-91.
  16. Li J, Tan H, Xu T, Shi H, Liu P. Bone marrow tracer uptake pattern of PET-CT in multiple myeloma: image interpretation and prognostic value. Ann Hematol. 2021 Dec;100(12):2979-88.
  17. Or O, Saiyed R, Marty E, Boyer A, Jahnwar YS, Niesvizky R, Lane JM. Prediction of long bone fractures in multiple myeloma patients in an advanced imaging world. Isr Med Assoc J. 2021 Aug;23(8):501-5.
  18. Shieh AC, Faraji N, Smith D, Parikh K, Ramaiya NH. Utility and clinical implications of appendicular skeleton magnetic resonance imaging in multiple myeloma: a single-institutional 15-year experience. J Comput Assist Tomogr. 2021 Nov-Dec 01;45(6):904-11.
  19. Abe Y, Narita K, Kobayashi H, Kitadate A, Takeuchi M, O'uchi T, Matsue K. Medullary abnormalities in appendicular skeletons detected with 18F-FDG PET/CT predict an unfavorable prognosis in newly diagnosed multiple myeloma patients with high-risk factors. AJR Am J Roentgenol. 2019 Oct;213(4):918-24.
  20. Terao T, Machida Y, Hirata K, Kuzume A, Tabata R, Tsushima T, Miura D, Narita K, Takeuchi M, Tateishi U, Matsue K. Prognostic impact of metabolic heterogeneity in patients with newly diagnosed multiple myeloma using 18F-FDG PET/CT. Clin Nucl Med. 2021 Oct 1;46(10):790-6.
  21. Martí A, Morón S, Chinchilla S, González E. PET/CT F18-FDG with soft tissue plasmacytomas in multiple myeloma. Eur J Hybrid Imaging. 2021 Mar 31;5(1):6.
  22. Takahashi MES, Mosci C, Duarte GO, Pericole FV, Metze K, Lorand-Metze IGH, Ramos CD. Intensity of bone involvement: a quantitative 18F-FDG PET/CT evaluation for monitoring outcome of multiple myeloma. Nucl Med Commun. 2021 Dec 1;42(12):1375-81.
  23. Lan L, Liu H, Wang Y, Deng J, Peng D, Feng Y, Wang L, Chen Y, Qiu L. The potential utility of [(68) Ga]Ga-DOTA-FAPI-04 as a novel broad-spectrum oncological and non-oncological imaging agent-comparison with [(18)F]FDG. Eur J Nucl Med Mol Imaging. 2022 Feb;49(3):963-79.
  24. Li J, Zhang X, Qin C, Sun X, Xu X, Cao G, Gai Y, Sun C, Hu Y, Lan X. A prognostication system based on clinical parameters and [18F]-FDG PET/CT in patients with newly diagnosed multiple myeloma. Eur J Nucl Med Mol Imaging. 2023 May;50(6):1665-70
  25. Wan B, Zhang S, Wang P, Deng P, Dai W. Prognostic value of semi-quantitative parameters of 18F-FDG PET/CT in newly diagnosed multiple myeloma patients. Ann Nucl Med. 2023 Mar;37(3):155-65.
  26. Cheng X, Cui R, Li F, Zhuang H. Lesions of multiple myeloma adjacent to the skull are better visualized on F-18 fluoroethyldimethyl-2-hydroxyethylammonium (FECH) PET images than on F-18 FDG PET images. Clin Nucl Med. 2011 Oct 1;36(10):912-4.
  27. Wang Y, Yee A, Bernstein Z, O'Donnell E, Raje N, Mahmood U. Carbon-11-Labeled Methionine PET/CT in patients with FDG-occult multiple myeloma: a prospective pilot study. AJR Am J Roentgenol. 2023 Apr;220(4):578-9.

Files

Share

How to cite

Statistics