Abstract
The optimal method of tumor burden evaluation in newly diagnosed multiple myeloma (NDMM) is yet to be determined. This study aimed to compare the value of 11C-acetate positron-emission tomography (PET)/computed tomography (CT) (AC-PET and 18F-fluorodeoxyglucose PET/CT (FDG-PET) in the assessment of tumor burden in NDMM.This study evaluated 64 NDMM patients between February 2015 and July 2018. AC-PET and FDG-PET were used to assess myeloma lesions. The clinical data, imaging results, and their correlations were analyzed. Diffuse bone marrow uptake in AC-PET was significantly correlated with biomarkers for tumor burden, including serum hemoglobin (P = 0.020), M protein (P = 0.054), the percentage of bone marrow plasma cells (P < 0.001), and the Durie–Salmon stage of the disease (P = 0.007). The maximum standard uptake value (SUVmax) of focal lesions and high diffuse bone marrow uptake in AC-PET showed stronger correlations with high-risk disease (P = 0.017, P = 0.013) than those in FDG-PET. Moreover, the presence of diffuse bone marrow uptake, more than ten focal lesions, and an SUVmax of focal lesions of > 6.0 in AC-PET, but not in FDG-PET, predicted a higher probability of disease progression and shorter progression-free survival (P < 0.05). AC-PET outperformed FDG-PET in tumor burden evaluation and disease progression prediction in NDMM.
Highlights
The optimal method of tumor burden evaluation in newly diagnosed multiple myeloma (NDMM) is yet to be determined
Multiple myeloma (MM), a malignant plasma cell proliferative disorder characterized by bone marrow infiltration and the production of abnormal monoclonal immunoglobulin known as M-protein, can lead to impaired immune function, high blood viscosity, and multiple organ damage, kidney damage[1]
In this prospective cohort study, newly diagnosed MM (NDMM) patients who were admitted to the Hematology Department of Peking Union Medical College Hospital, China, between February 2015 and July 2018 were enrolled in this study
Summary
The optimal method of tumor burden evaluation in newly diagnosed multiple myeloma (NDMM) is yet to be determined. The Durie–Salmon (D–S) staging system has been used to approximate the tumor burden since 19753, which demonstrates the correlation between the amount of myeloma and the damage it has caused It uses the results of blood tests, urine tests, and X-ray radiographs. Conventional radiographs such as magnetic resonance imaging (MRI) and computed tomography (CT) were generally utilized to detect myelomaassociated bone destruction[4] Advanced techniques such as whole-body (WB) 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/CT (FDG-PET) or WB MRI were proposed to yield more accurate results in the D–S PLUS staging system[5]. The current study aimed to compare the value of AC-PET and FDG-PET in detecting myeloma lesions, evaluating tumor burden, stratifying disease risk, and predicting prognosis in patients with NDMM
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