Abstract
Objective: In this study, we aimed to compare [68Ga]FAPI PET/CT and [18F]FDG PET/CT imaging to detect lesions in multiple myeloma. Methods: A total of 14 patients with multiple myeloma who underwent [68Ga]FAPI PET/CT and [18F]FDG PET/CT imaging were included in this retrospective study. SUVmax values of [68Ga]FAPI and [18F]FDG were compared according to lesion locations. Also, lesion localization ability of both imaging methods was compared on the patient basis. Results: In 4 of 14 patients, [68Ga]FAPI PET/CT and [18F]FDG PET/CT have not detected any bone lesions. In 8 of the remaining 10 patients [18F]FDG PET/CT detected bone lesions but in this group, 6 patients showed more higher SUVmax values than [18F]FDG PET/CT in [68Ga]FAPI PET/CT.In contrast, 2 of 8 patients showed more higher SUVmax values than [68Ga]FAPI PET/CT in [18F]FDG PET/CT. Moreover, [68Ga]FAPI PET/CT detected bone lesions in two patients, which werenot detected by [18F]FDG PET/CT. Also, in five patients, [68Ga]FAPI PET/CT showed more bone lesions in comparison with[18F]FDG PET/CT. Only one patient, [18F]FDG PET/CT showed more bone lesions. Three extramedullary involvements were observed in the following locations: lung, presacral lymph node, and soft tissue mass lateral to the right maxillary sinus. Among these involvements, higher SUVmax values were observed in the lung and presacral lymph node with [68Ga]FAPI compared to [18F]FDG. However, the soft tissue mass showed a higher SUVmax value in [18F]FDG than [68Ga]FAPI. Conclusions: No significant superiority was observed in [68Ga]FAPI PET/CT over [18F]FDG PET/CT in patients with MM. However, [68Ga]FAPI PET/CT can be utilized as a complementary imaging method to [18F]FDG PET/CT in some settings, especially in low-[18F]FDG affinity and inconclusive cases. Considering the favorable aspects of [68Ga]FAPI PET/CT in MM, such as low background activity, absence of non-specific bone marrow, and physiological brain involvement, further studies with a larger sample size should be conducted.
Highlights
Introduction conditions of the Creative CommonsMultiple myeloma (MM) is a neoplastic disease of the bone characterized by uncontrolled clonal proliferation of plasma cells
Detection of osteolytic bone lesions and end-organ damage closely associated with the disease is essential to determine the need for immediate treatment [3]
Skeletal examinations have been replaced by whole body computed tomography (CT), whole body magnetic resonance imaging (MRI)
Summary
Introduction conditions of the Creative CommonsMultiple myeloma (MM) is a neoplastic disease of the bone characterized by uncontrolled clonal proliferation of plasma cells. Of patients and during disease in almost all patients [1,2] For this reason, imaging plays a very important role in the diagnosis of MM, which ismainly based on bone involvement. Skeletal examinations have been replaced by whole body CT (computed tomography), whole body MRI (magnetic resonance imaging), or [18F]FDG PET/CT (18F-fluoro-deoxy-glucose positron emission tomography) in routine studies to identify lesions that define MM. Both MRI and [18F]FDG PET/CT have the advantage of evaluating bone marrow-occupying lesions before bone resorption is seen on CT [6].
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