scholarly journals Long Term Results of a Multicenter Prospective Trial By the Lysa Group Evaluating the RiPAD+C Regimen (Combination of Rituximab, Bortezomib, Doxorubicin, Dexamethasone and Chlorambucil) As First-Line Therapy for Elderly Mantle Cell Lymphoma Patients (MCL): Prognostic Value of FDG-PET/CT

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3070-3070 ◽  
Author(s):  
Julien Dubreuil ◽  
Roch Houot ◽  
Steven Le Gouill ◽  
Christiane Mounier ◽  
Stéphane Courby ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Research Funding ◽  
Standardized Uptake Value ◽  
Post Treatment ◽  
Prognostic Impact ◽  
Pet Ct ◽  
Mantle Cell ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

Abstract Background: Mantle cell lymphoma (MCL) is an aggressive lymphoma with variable 18Fluorine-Deoxyglucose (FDG) avidity. FDG - Positron Emission Tomography/Computed Tomography (FDG-PET/CT) is not yet recommended in MCL but many retrospective studies have underlined its prognostic impact either before any treatment or at interim or final time points of R-chemotherapy. The French LYSA/GOELAMS group published the results of a multicenter prospective phase II clinical trial evaluating the RiPAD + C front-line combination including one proteasome inhibitor (PS341-Velcade®) for elderly MCL patients(Houot, Le Gouill et al. 2012). The aim of the present study was to determine the prognostic value of FDG-PET/CT in this prospective cohort with a long follow up. Method: Patients between 65 and 80 years old were enrolled. They received 4 cycles of RiPAD+C regimen (every 35 days: Rituximab 375 mg/sqm D1, Velcade® 1.3 mg/sqm D1,4,8 and 11, Doxorubicin 9 mg/sqm D1 to D4, Dexamethasone 40 mg D1 to 4 and Chlorambucil 12 md D20 to D29) and 2 additional cyclesif they responded (IWR criteria). Three FDG-PET scans were performed: an initial pre-treatment, after 4 cycles (interim) and after 6 cycles (post-treatment). All available FDG-PET/CT were centrally reviewed by two experts, using visual international response assessment criteria proposed by IHP in Lymphoma and the Deauville five-point scale. The maximal standardized uptake value (SUVmax) and maximal standardized uptake value reduction (ΔSUVmax) of the most intense pathological area were measured. Results: From June 2007 to December 2008, 39 patients from 21 French centers were recruited. After 64 months follow-up for the 22 surviving patients, median overall survival (OS) has not been reached (the 3 year OS was 63,5%). Median progression free survival (PFS) is 22 months. Seventeen patients died either from lymphoma (n=13) or due to toxicity (n=4). Seventy-eight FDG-PET/CT were performed (31 initial FDG-PET/CT; 28 interim, 19 post-treatment), in 39 patients. We reviewed 24 initial FDG-PET/CT, 27 interim, and 16 post-treatment. By univariate analysis: neither initial, interim nor post-treatment FDG-PET/CT were predictive of OS or PFS. The ΔSUVmax (> 65% vs ≤ 65%, or > 50% vs ≤ 50%) was also not predictive for OS or PFS (p= 0.48 to 0.92). However high SUVmax (>10 vs ≤10) and clinical prognostic scores (MIPI or the Goelams index) correlated with OS (p=0.09, p= 0.054 and p=0.16, respectively). In a multivariate analysis patients with a high prognostic score at diagnosis combined with a positive post-treatment FDG-PET/CT had very poor OS compared to other profiles (high index with a negative post-treatment FDG-PET/CT or low-intermediate index with a negative or positive FDG-PET/CT). Conclusion: This is the first prospective study evaluating the prognostic impact of FDG-PET/CT in a cohort of homogeneously treated MCL patients with a long time of follow up. Neither initial, interim or post-treatment FDG-PET/CT were predictive of PFS or OS. However we confirm, as previously described in a retrospective analysis (Bodet-Milin, Touzeau et al. 2010), that both high SUVmax at initial FDG-PET/CT and the MIPI score were prognostic for OS. Interestingly, a negative post-treatment FDG-PET/CT seemed to erase the adverse prognostic significance of a high MIPI score before treatment. These observations warrant further confirmation in large prospective clinical trials. Disclosures Le Gouill: Roche: Consultancy; Janssen: Consultancy. Dartigeas:Roche: Consultancy. Tournilhac:mundipharma: Honoraria, Other, Research Funding; GSK: Honoraria, Other, Research Funding; Roche: Honoraria, Other, Research Funding. Gressin:MundiPharma: Other.

scholarly journals 18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Alaa Mouminah ◽  
Austin J. Borja ◽  
Emily C. Hancin ◽  
Yu Cheng Chang ◽  
Thomas J. Werner ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Post Treatment ◽  
Parotid Glands ◽  
Positron Emission ◽  
Pet Ct ◽  
Average Maximum ◽  
Pre Treatment ◽  
Fdg Pet Ct

Abstract Background 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used in the clinical management of oncologic and inflammatory pathologies. It may have utility in detecting radiotherapy (RT)-induced damage of oral tissues. Thus, the aim of the present study was to use FDG-PET/CT to evaluate parotid gland inflammation following RT in patients with head and neck cancer (HNC). Methods This retrospective study included patients with HNC treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All patients received FDG-PET/CT imaging pre-treatment and 3 months post-treatment. The average mean standardized uptake value (Avg SUVmean) and the average maximum standardized uptake value (Avg SUVmax) of the left and right parotid glands were determined by global assessment of FDG activity using OsiriX MD software. A two-tailed paired t test was used to compare Avg SUVmean and Avg SUVmax pre- and post-RT. Results Forty-seven HNC patients were included in the study. Parotid gland Avg SUVmean was significantly higher at 3 months post-treatment than pre-treatment (p < 0.05) in patients treated with photon RT, but no significant differences were found between pre- and post-treatment Avg SUVmean in patients treated with proton RT or combined photon/proton RT. Conclusion Our results suggest that photon RT may cause radiation-induced inflammation of the parotid gland, and that proton RT, which distributes less off-target radiation, is a safer treatment alternative.

Prognostic Impact of Standardized Uptake Value of F-18 FDG PET/CT in Nasopharyngeal Carcinoma

2011 ◽  
Vol 36 (11) ◽  
pp. 1007-1011 ◽  
Author(s):  
Winnie K. S. Chan ◽  
Dora Lai-Wan Kwong ◽  
David W. C. Yeung ◽  
Bingsheng Huang ◽  
Pek-Lan Khong
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Prognostic Impact ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Pulmonary Findings of [18F]FDG PET/CT Images on Asymptomatic COVID-19 Patients

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 839
Author(s):  
Tzu-Chuan Ho ◽  
Chin-Chuan Chang ◽  
Hung-Pin Chan ◽  
Ying-Fong Huang ◽  
Yi-Ming Arthur Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Fdg Uptake ◽  
Asymptomatic Patients ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: “asymptomatic”, “COVID-19”, “[18F]FDG PET/CT”, and “nuclear medicine” were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 ± 14.85 years (male: 67.71 ± 12.00; female: 56.79 ± 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 ± 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 ± 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET/CT of asymptomatic patients with COVID-19.

scholarly journals Potential role of post‑treatment follow‑up FDG‑PET CT to detect mandibular osteoradionecrosis: A case report

2017 ◽  
Author(s):  
Masaya Akashi ◽  
Satoshi Wanifuchi ◽  
Junya Kusumoto ◽  
Megumi Kishimoto ◽  
Yasumasa Kakei ◽  
...  
Keyword(s):  
Case Report ◽  
Fdg Pet ◽  
Potential Role ◽  
Post Treatment ◽  
Pet Ct ◽  
Fdg Pet Ct

Initial [18F]FDG PET/CT in high-risk DTC patients

2016 ◽  
Vol 55 (03) ◽  
pp. 99-103 ◽  
Author(s):  
Ina Binse ◽  
Andreas Bockisch ◽  
Sandra Rosenbaum-Krumme ◽  
Marcus Ruhlmann
Keyword(s):  
High Risk ◽  
Fdg Pet ◽  
Patient Management ◽  
Whole Body ◽  
Prognostic Impact ◽  
Full Remission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryIn a previous paper, we published the impact of initial [18F]FDG PET/CT (FDG-PET/CT) in high-risk patients with differentiated thyroid cancer (DTC) and described the changes in therapy management. The aim of the present study was to evaluate the prognostic impact of the initial FDG-PET/CT on a patient’s follow-up over three years and the rate of complete remission. Patients, methods: This study included 109 DTC patients who underwent radioiodine treatment (RIT), including posttherapeutic whole-body scintigraphy with FDG-PET/CT and a follow-up over three years. The follow-up included high-resolution sonography of the neck and determination of serum Tg as well as Tg antibodies every six months. The results of initial FDG-PET/CT and whole-body scintigraphy were compared with the status after three years of follow-up. Results: 24/109 patients (22%) presented FDG-positive lesions, 22/109 patients (20%) only iodine-positive lesions, and 63/109 patients (58%) neither FDG-positive nor iodine-positive lesions. After three years, 83/109 patients (76%) revealed full remission, 15/109 patients (14%) tumour persistence and 11/109 patients (10%) a progressive disease. The negative predictive value (NPV) was calculated for patients without FDG-positive lesions (NPV 85%) and patients without any lesions (NPV 91%) regarding full remission in the follow-up. Conclusion: FDG-PET/CT has a high NPV (85% to 91%) in DTC patients regarding recurrence-free follow-up after three years. The change in patient management in patients with iodine-negative lesions can lead to a higher rate of full remissions in the follow-up after additional surgery. Therefore, FDG-PET/ CT should be performed in all high-risk DTC patients in the context of the first RIT to improve patient management and risk stratification.

scholarly journals Clinical relevance of 18F-FDG PET/CT in the postoperative follow-up of patients with history of medullary thyroid cancer

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jelena Saponjski ◽  
Djuro Macut ◽  
Dragana Sobic Saranovic ◽  
Branislava Radovic ◽  
Vera Artiko
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Somatostatin Receptor ◽  
False Negative ◽  
Standardized Uptake Value ◽  
True Negative ◽  
Medullary Thyroid ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractBackgroundThe aim of the study was evaluation of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography with computed tomography (PET/CT) in the detection of active disease in the patients with suspected recurrence of the medullary thyroid carcinoma (MTC).Patients and methods18F-FDG PET/CT investigation was performed in 67 patients, investigated from 2010 to 2019. _ Follow up was performed from 6 to 116 months after surgery (median 16.5 months, x± SD = 29±28.9 months). Twenty five of 67 patients underwent 99mTc-dimercaptosuccinic acid (99mTc-DMSA) scintigraphy, 11 underwent somatostatin receptor scintigraphy (SRS) with 99mTc-HYNIC TOC while 11 123I-metaiodobenzylguanidine (MIBG) scintigraphy.ResultsFrom 67 patients, 35 (52.2%) had true positive 18F-FDG PET/CT findings (TP). Average maximal standardized uptake value (SUVmax) for all TP lesions was 5.01+3.6. In 25 (37.3%) patients findings were true negative (TN). Four (6%) patients had false positive (FP) findings while three (4.5%) were false negative (FN). Thus, sensitivity of the 18F-FDG PET/ CT was 92.11%, specificity 86.21%, positive predictive value 89.74%, negative predictive value 89.29% and accuracy 89.55%. In 27 patients (40%) 18F-FDG PET/CT finding influenced further management of the patient.Conclusions18F-FDG PET/CT has high accuracy in the detection of metastases/recurrences of MTC in patients after thyroidectomy as well as in evaluation and the appropriate choice of the therapy.

Result of FDG PET-CT Imaging After Immunochemotherapy Induction Is a Powerful and Independent Prognostic Indicator of Outcome for Patients with Follicular Lymphoma: An Analysis From the PRIMA Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 855-855 ◽  
Author(s):  
Judith Trotman ◽  
Marion Fournier ◽  
Thierry Lamy ◽  
Jane A Estell ◽  
Anne Sonet ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Fdg Pet ◽  
Cox Model ◽  
Response Assessment ◽  
Post Treatment ◽  
Ct Scans ◽  
Induction Treatment ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Abstract 855 Aim: Despite its often indolent clinical course, follicular lymphoma (FL) is a heterogeneous disease. Current criteria for early identification of patients with a poor prognosis are suboptimal - the FLIPI and F2 index are insufficient prognostic markers for individual patients and the limitations of post-treatment conventional response criteria have long been acknowledged. FL shows increased FDG uptake, but unlike DLBCL, minimal data exist about the role of PET-CT in response assessment. We have used the prospective conventional response assessment and 42 month patient follow-up in the PRIMA (Primary Rituximab and Maintenance, Salles et al., ASCO 2010, Abstr#8004) study as a platform for analysis of the utility of PET-CT in FL. Methods: The PRIMA database was interrogated and investigators surveyed to identify PET-CT scans performed during staging and induction response assessment. Single modality PET-only scans were not eligible for inclusion. Local PET interpretation (positive + or negative -) was used to explore associations with patient outcomes. The primary endpoint was PFS from PRIMA registration. Results: 277 PET-CT scans on 160 patients from 40 centres were identified. Baseline patient characteristics did not differ from the overall PRIMA patient population. Positive PET-CT scans were recorded in 119/120 (99%) at diagnosis, 11/33 (33%) interim restaging scans and 32/124 (26%) post induction treatment (R-CHOP or R-CVP). There was significant correlation between PET-CT result and conventional response assessment at the end of immunochemotherapy (p<0.0005). The incidence of post-treatment PET+ increased across the categories of lesser conventional responses, occurring in 8% (4/50) CR, 31% (12/39) CRu, 41% (11/37) PR, 67% (2/3) SD, and 80% (4/5) PD. While 73/91 (80%) of PET- patients were in CR/CRu, given the very high overall response rate on study, 16/33 (48%) of the PET+ population were also in CR/CRu. With a median follow-up of 42 months, a significantly inferior actuarial 3yr PFS was observed in post-treatment PET+ vs. PET- patients (Figure 1): 32% (95% CI 17–48%) vs. 74% (95% CI 63–82%) (log rank p<0.0001, HR 3.5, 95% CI 2.0–6.1), median PFS 19 months (13-35) vs. not reached, (52-NR). Using proportional hazard regression analysis, both conventional response (overall p=0.0002) and PET+ status (HR 2.8 p=0.0007) were significant predictors of inferior PFS. However, the predictive power of conventional response assessment was limited to non-responders: SD/PD vs. CR/CRu (HR 6.5, p<0.0001), and SD/PD vs. PR (HR 5.2, p=0.0009). Comparison of PR vs. CR/CRu was not different (HR 1.2, p=0.5). While PET+ status had a significant negative impact on PFS in both the CR/CRu (HR 2.6, p=0.015) and PR (HR 4.3 p=0.018) patient groups, there was no difference in outcome between CR/CRu vs. PR patients within the PET+ (HR 1.5 p=0.42) and PET- (HR 1.0 p=0.98) subgroups. When only patients randomised for the maintenance element of the PRIMA study were considered, post-treatment PET+ (15/59) remained predictive of 3yr PFS (27 vs. 69%, HR 3.1, p=0.005) in the observation arm, but post-treatment PET+ (9/47) was not significantly associated with an adverse outcome in patients receiving rituximab maintenance (3-year PFS 56 vs. 81%, HR 2.2, p= 0.18). In a multivariate Cox model including responding patients the following factors were negative predictors of PFS: post-treatment PET+ (HR 3.1 p<0.0014); R-CVP induction therapy (HR 2.8, p<0.014); and baseline β2M ≥3 (HR 2.6 p<0.0042), while conventional PR and FLIPI were not. Conclusion: This PRIMA sub-study demonstrates that post-treatment PET-CT is a powerful predictor of PFS that complements conventional response evaluation after first line immunochemotherapy for FL. Patients who are PET- can expect a prolonged PFS whether in conventional CR or PR, but for those remaining PET+, with a median 19 month PFS, the disease cannot be characterized as indolent. Future clinical trials should evaluate an FDG PET-CT response adapted approach focused on improving outcomes for this group. Disclosures: Seymour: Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Shpilberg:Roche: Consultancy, Honoraria.

scholarly journals The clinical impact of incidental sellar uptake on F-18 FDG PET/CT

2019 ◽  
Vol 6 (2) ◽  
pp. IJE15
Author(s):  
Zehra Pınar Koç ◽  
Pelin Özcan Kara ◽  
Emel Sezer ◽  
Kadir Eser ◽  
Anıl Özgür
Keyword(s):  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Sellar Region ◽  
Primary Tumors ◽  
Fdg Uptake ◽  
Pet Ct ◽  
Frequent Finding ◽  
Metastatic Involvement ◽  
Fdg Pet Ct

Aim: The most frequent finding associated with incidental fluorodeoxyglucose (FDG) uptake in sellar region in oncologic F-18 FDG PET/CT is adenoma. However, reports of metastatic involvement exist. We investigated the clinical significance of incidental FDG uptake in this region. Materials & method: 34 patients with several primary tumors who were referred for staging, restaging or treatment response via F-18 FDG PET/CT were included. Images were reviewed and patients with significant FDG uptake in the sellar region were referred. Results: Mean lesion diameter was 11.9 ± 4.9 mm and mean standardized uptake value was 8.2 ± 6.1. Thirteen patients underwent MRI, and the others underwent follow-up F-18 FDG PET/CT. MRI revealed metastatic involvement in nine patients and macro- or micro-adenoma in four. Metastatic patients also had other lesions, yet management did not change. Conclusion: FDG accumulation in the sellar region might be associated with metastasis or adenoma. However, it did not change management. Future studies are warranted.

scholarly journals Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized Care

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Bingfeng Tang ◽  
Malaykumar M. Patel ◽  
Regina H. Wong ◽  
Daniel Wood ◽  
Christiana O. Wong ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Standardized Uptake Value ◽  
B Cell Lymphoma ◽  
Metabolic Changes ◽  
Personalized Care ◽  
Pet Ct ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

Purpose. The aims were to correlate individual marrow metabolic changes after chemotherapy with bone marrow biopsy (BMBx) for its potential value of personalized care in lymphoma. Methods. 26 patients (mean age, 58 ± 15 y; 13 female, 13 male) with follicular lymphoma or diffuse large B-cell lymphoma, referred to FDG-PET/CT imaging, who had BMBx from unilateral or bilateral iliac crest(s) before chemotherapy, were studied retrospectively. The maximal standardized uptake value (SUV) was measured from BMBx site over the same area on both initial staging and first available restaging FDG-PET/CT scan. Results. 35 BMBx sites in 26 patients were evaluated. 12 of 35 sites were BMBx positive with interval decrease in SUV in 11 of 12 sites (92%). The remaining 23 of 35 sites were BMBx negative with interval increase in SUV in 21 of 23 sites (91%). The correlation between SUV change over the BMBx site before and after chemotherapy and BMBx result was significant (P<0.0001). Conclusions. This preliminary result demonstrates a strong correlation between marrow metabolic changes (as determined by FDG PET) after chemotherapy and bone marrow involvement proven by biopsy. This may provide a retrospective means of personalized management of marrow involvement in deciding whether to deliver more extended therapy or closer followup of lymphoma patients.

scholarly journals Longitudinal 18f-FDG-PET-CT Analysis in Newly Diagnosed Multiple Myeloma (NDMM) Patients Following Carfilzomib, Lenalidomide, Dexamethasone Induction and Lenalidomide Maintenance (CRd-R)

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3274-3274
Author(s):  
Neha S Korde ◽  
Dickran Kazandjian ◽  
Mark Roschewski ◽  
Sham Mailankody ◽  
Malin Hultcrantz ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Fdg Pet ◽  
Research Funding ◽  
Residual Disease ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Over Time

Abstract Introduction: Multiple myeloma (MM) is a patchy bone marrow based malignancy of plasma cells, resulting in painful bone lytic lesions that can be visualized by 18F-FDG-PET-CT. We treated 45 NDMM patients with CRd-R therapy that resulted in high rates of minimal residual disease (MRD) negativity (62%)(Korde et al. JAMA Onc 2015). In this study, we assessed longitudinal FDG response through lenalidomide (Len) maintenance period and aimed to correlate with clinical findings and MRD status. Methods: The details of treatment received, study design and patients' characteristics have already been published. As part of the study design, all patients had serial PET imaging at baseline, after achievement of CR and/or at completion of 8 cycles of CRd, and at year-1 and -2 of Len maintenance, or termination of protocol therapy. Whole body (vertex to toes) static FDG imaging was performed at 1-hour post injection, implemented according to institutional practice. Focal lesions on FGD were defined as: increased uptake (above background reference) within the bone, (excluding articular regions due to high prevalence and likelihood of confounding arthritic disease), maximum standardized uptake value (SUV) >1.5 for lesion size on CT ranging from 0.5-1.0 cm, or maximum SUV >2.5 for lesions >1.0 cm. Results: At baseline, 37/45(82.2%) patients had FDG-positive lesions and 8/45(17.8%) were negative. Median follow-up for longitudinal analysis is 30.1 months. Among initial FDG-negative patients, 7/8 (87.5%) patients remained negative throughout follow-up; 1/8 (12.5%) patients developed a sclerotic FDG-positive lesion deemed not to be progression (rib 5 SUV 1.7). Among the 37 patients with baseline FDG-positive lesions, 12/37(32.4%) patients had complete resolution of FDG-PET-CTs (FDG-responders); 25/37(67.5%) remained FDG-long-term positive at time of last protocol scan. Eight of the 25(32%) FDG-long-term positive patients met IMWG criteria for progression, compared to 0/12 FDG-responders (p value=0.04). For patients with available data, MRD negative status after initial CRd (prior to Len maintenance) was not associated with long-term PET-CT response [19/24(79.2%) vs. 8/11(72.7%), FDG-long-term positive vs. FDG-responders, p=NS]. For the remaining FDG-long-term positive patients not meeting progression criteria, all 17 patients had low-positive persistent FDG with decreased or partial SUV response that decreased over time while on Len maintenance. Conclusions: In patients receiving CRd followed by long-term Len maintenance, 68% of baseline FDG-positive patients have persistent longitudinal FDG-positive myeloma lesions. While there is an increased risk of clinical progression among these patients, the majority showed low-positive FDG lesion uptake that decreased over time with long-term Len maintenance. Long-term resolution of FDG-positive lesions is not associated with MRD status after initial CRd therapy. Further follow-up is needed to examine the significance of persistent FDG-positive lesions in relationship to residual disease and mechanisms of resistance. Figure Figure. Disclosures Korde: Medscape: Honoraria. Hassoun:Takeda: Consultancy, Research Funding; Celgene: Research Funding; Novartis: Consultancy; Binding Site: Research Funding. Landgren:Medscape Myeloma Program: Honoraria; BMS: Honoraria; Merck: Honoraria; Takeda: Honoraria; Amgen: Honoraria, Research Funding; Celgene: Honoraria, Research Funding.

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