Abstract 2634: Predictive value of18F-FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma

Purpose 18F-FDG PET/CT (PET/CT) could be a valuable tool to predict long-term survival outcomes in patients with newly diagnosed multiple myeloma (MM). It has ability to distinguish metabolically active sites such as extramedullary disease (EMD) as well as bone damage with relatively high sensitivity and specificity. In this study, we attempted to evaluate the role of PET-CT as a novel prognostic tool for patients with newly diagnosed MM who have EMD. Patients and Methods This study included 211 patients who were newly diagnosed with multiple myeloma from Kyunpook National University Hospital and Chonnam National University Hwasun Hospital. We retrospectively analyzed the medical records of enrolled patients. PET/CT was performed at the diagnosis and EMD was identified in 36 patients (17.1%). Results With a median follow-up duration of 21.5 months (range 1.4-67.7), the estimated 2-year PFS and OS rates were 46.1% and 79.6%, respectively. The presence of PET/CT positive EMD and high maximum standardized uptake value (SUVmax) on baseline PET/CT were significantly associated with inferior long-term survivals in terms of PFS (p=0.013, p=0.007) and OS (p=0.002, p=0.004). In addition, patients who underwent autologous stem cell transplantation (auto-SCT) showed superior PFS (p=0.005) and OS (p=0.022) in PET/CT positive EMD group. Meanwhile, Revised-International Staging System (R-ISS) successfully predicted the prognosis in this study. When we modified R-ISS with the presence of EMD, survival outcomes of the R-ISS stage III patients who didn't have EMD were similar to R-ISS II, while patients with PET/CT positive EMD showed even worse prognosis than the R-ISS stage III group. In the multivariate survival analysis, the presence of EMD (hazard ratio (HR), 2.397; 95% confidence internal (CI), 1.281-4.483; p=0.006) and auto-SCT (HR, 0.326; 95% CI, 0.194-0.549; p<0.001) were related to PFS, while LDH (HR, 2.56; 95% CI, 1.221-5.366; p=0.013) level and auto-SCT (HR, 0.398; 95% CI, 0.167-0.953; p=0.039) were independent prognostic factors of OS. Conclusion In conclusion, PET/CT positive EMD was a poor prognostic factor in patients with newly diagnosed MM. In addition, PET/CT could be a valuable tool to make better risk-adapted treatment strategies with R-ISS in EMD positive MM patients. Above all, patients with PET/CT positive EMD should be considered auto-SCT to improve long-term survivals. Figure Disclosures No relevant conflicts of interest to declare.

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Use of 18-F FDG PET / CT Scanning Into the First Follow Up of Patients with Multiple Myeloma and Association with Biochemical Response

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2017.03.268 ◽

2017 ◽

Vol 17 (1) ◽

pp. e149

Author(s):

Mercedes Gironella ◽

Juan Alfons Soler ◽

Marc Simó ◽

Carlos Palacio ◽

Julia Montoro ◽

...

Keyword(s):

Multiple Myeloma ◽

Fdg Pet ◽

Ct Scanning ◽

Biochemical Response ◽

Pet Ct ◽

Fdg Pet Ct

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Diagnostic Value of WB-DWI Versus 18 F-FDG PET/CT for the Detection of Multiple Myeloma

10.21203/rs.3.rs-20429/v1 ◽

2020 ◽

Author(s):

Bei Zhang ◽

Li Zhang ◽

Bingyang Bian ◽

Fang Lin ◽

Zining Zhu ◽

...

Keyword(s):

Multiple Myeloma ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

False Positive ◽

Fdg Pet ◽

Pet Ct ◽

Adc Values ◽

Sensitivity Specificity ◽

Fdg Pet Ct

Abstract BACKGROUND Whole body diffusion weighted imaging (WB-DWI) is commonly used for the detection of multiple myeloma (MM). Comparative data on the efficiency of WB-DWI compared with 18 F positron emission tomography computed tomography ( 18 F-FDG PET/CT) to detect MM are lacking. METHODS This was a retrospective, single-center study of twenty-two patients with MM enrolled from January 2019 to December 2019. All patients underwent WB-DWI and 18 F-FDG PET/CT. Pathological and clinical manifestations as well as radiologic follow-up were used for diagnosis. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of both methods were compared. The appearance diffusion coefficient (ADC) values of MM lesions and false-positive lesions were estimated. RESULTS A total of 214 MM bone lesions were evaluated. WB-DWI showed a higher overall accuracy than PET/CT (75.7% and 55.6%, respectively; < 0.05). However, for sensitivity, specificity, positive predictive value and negative predictive value, there were no significant differences for WB-DWI vs PET/CT (99.3% and 83.9%, 64.9% and 94.8%, 63.6% and 54.2%, 98.1% and 65.3%, respectively). The ADC value for MM lesions was significantly lower than that for false-positive lesions (p < 0.001). Receiver operating curve (ROC) curve analysis showed that the AUC was 0.846, and when the cut-off value was 0.745×10 -3 mm 2 /s, the sensitivity and specificity were 86.0% and 82.4%, respectively, which distinguished MM lesions from non-MM lesions. CONCLUSION WB-DWI may be a useful tool for the diagnosis of MM bone disease due to to higher overall accuracy and measurements of ADC values compared with PET/CT.

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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

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000001259 ◽

2020 ◽

Vol 41 (10) ◽

pp. 1081-1088

Author(s):

Camila Mosci ◽

Fernando V. Pericole ◽

Gislaine B. Oliveira ◽

Marcia T. Delamain ◽

Maria E.S. Takahashi ◽

...

Keyword(s):

Multiple Myeloma ◽

Fdg Pet ◽

Newly Diagnosed ◽

Similar Performance ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

99Mtc Sestamibi

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Development of a new risk stratification system for patients with newly diagnosed multiple myeloma using R-ISS and 18F-FDG PET/CT

Blood Cancer Journal ◽

10.1038/s41408-021-00577-2 ◽

2021 ◽

Vol 11 (12) ◽

Author(s):

Hee Jeong Cho ◽

Sung-Hoon Jung ◽

Jae-Cheol Jo ◽

Yoo Jin Lee ◽

Sang Eun Yoon ◽

...

Keyword(s):

Multiple Myeloma ◽

Risk Stratification ◽

Fdg Pet ◽

Survival Rates ◽

Newly Diagnosed ◽

Focal Lesions ◽

Pet Ct ◽

Stratification System ◽

Fdg Pet Ct ◽

Risk Stratification System

AbstractIn multiple myeloma (MM), a high number of focal lesions (FL) detected using positron emission tomography/computed tomography (PET/CT) was found to be associated with adverse prognosis. To design a new risk stratification system that combines the Revised International Staging System (R-ISS) with FL, we analyzed the data of 380 patients with newly diagnosed MM (NDMM) who underwent 18F-fluorodeoxyglucose (18F-FDG) PET/CT upon diagnosis. The K-adaptive partitioning algorithm was adopted to define subgroups with homogeneous survival. The combined R-ISS with PET/CT classified NDMM patients into four groups: R-ISS/PET stage I (n = 31; R-ISS I with FL ≤ 3), stage II (n = 156; R-ISS I with FL > 3 and R-ISS II with FL ≤ 3), stage III (n = 162; R-ISS II with FL > 3 and R-ISS III with FL ≤ 3), and stage IV (n = 31; R-ISS III with FL > 3). The 2-year overall survival rates for stages I, II, III, and IV were 96.7%, 89.8%, 74.7%, and 50.3%. The 2-year progression-free survival rates were 84.1%, 64.7%, 40.8%, and 17.1%, respectively. The new R-ISS/PET was successfully validated in an external cohort. This new system had a remarkable prognostic power for estimating the survival outcomes of patients with NDMM. This system helps discriminate patients with a good prognosis from those with a poor prognosis more precisely.

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Medullary Abnormalities in Appendicular Skeletons Detected With18F-FDG PET/CT Predict an Unfavorable Prognosis in Newly Diagnosed Multiple Myeloma Patients With High-Risk Factors

American Journal of Roentgenology ◽

10.2214/ajr.19.21283 ◽

2019 ◽

Vol 213 (4) ◽

pp. 918-924 ◽

Cited By ~ 4

Author(s):

Yoshiaki Abe ◽

Kentaro Narita ◽

Hiroki Kobayashi ◽

Akihiro Kitadate ◽

Masami Takeuchi ◽

...

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

High Risk ◽

Fdg Pet ◽

Newly Diagnosed ◽

High Risk Factors ◽

Pet Ct ◽

Fdg Pet Ct

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18F-FDG PET/CT Findings and Baseline Clinical Parameters in Multiple Myeloma

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2017.03.267 ◽

2017 ◽

Vol 17 (1) ◽

pp. e148-e149

Author(s):

Tulin Firatli Tuglular ◽

Funda Pepedil Tanrikulu ◽

Tayfur Toptas ◽

Asli Karadeniz ◽

Isik Atagunduz

Keyword(s):

Multiple Myeloma ◽

Fdg Pet ◽

Clinical Parameters ◽

Ct Findings ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Nomograms based on SUVmax of 18F-FDG PET/CT and clinical parameters for predicting progression-free and overall survival in patients with newly diagnosed extranodal natural killer/T-cell lymphoma

Cancer Imaging ◽

10.1186/s40644-020-00379-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hongyan Li ◽

Guozhu Shao ◽

Yajing Zhang ◽

Xiaomin Chen ◽

Chengcheng Du ◽

...

Keyword(s):

Overall Survival ◽

Fdg Pet ◽

Cell Lymphoma ◽

Prognostic Index ◽

Clinical Parameters ◽

Newly Diagnosed ◽

Natural Killer T Cell ◽

Pet Ct ◽

Fdg Pet Ct ◽

Killer T Cell

Abstract Background The prognostic value of 18F-FDG PET/CT in extranodal natural killer/T-cell lymphoma (ENKTL) is not well established. We aimed to develop nomograms for individualized estimates of progression-free survival (PFS) and overall survival (OS) in patients with ENKTL using 18F-FDG PET/CT parameters and clinical parameters. Methods A total of 171 patients with newly diagnosed ENKTL undergoing 18F-FDG PET/CT scanning were retrospectively analyzed. Nomograms were constructed according to multivariate Cox proportional hazards regression. The predictive and discriminatory capacities of the nomograms were then measured using the concordance index (C-index), calibration plots, and Kaplan-Meier curves. The C-index, the area under receiver operating characteristic (ROC) curve (AUC), and decision curve analysis (DCA) were used to contrast the predictive and discriminatory capacities of the nomograms against with the International Prognostic Index (IPI) and Korean Prognostic Index (KPI). Results Multivariate analysis demonstrated that pretreatment SUVmax≥9.5, disease stage II and III-IV, elevated lactate dehydrogenase (LDH), and elevated β2-microglobulin (β2-MG) had the strongest association with unfavorable PFS and OS. In addition, hemoglobin (Hb) < 120 g/L had a tendency to be associated with PFS. Both nomogram models incorporated SUVmax, Ann Arbor stage, LDH, and β2-MG. The PFS nomogram also included Hb. The nomograms showed good prediction accuracies, with the C-indexes for PFS and OS were 0.729 and 0.736, respectively. The calibration plots for 3-year and 5-year PFS/OS reported good consistency between predicted and observed probabilities for survival time. The PFS and OS were significantly different according to tertiles of nomogram scores (p < 0.001). The C-index and AUCs of the nomograms were higher than that of IPI and KPI. Moreover, DCA showed that the predictive accuracy of the nomograms for PFS and OS were both higher than that of IPI and KPI. Conclusions This study established nomograms that incorporate pretreatment SUVmax and clinical parameters, which could be effective tools for individualized prognostication of both PFS and OS in patients with newly diagnosed ENKTL.

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