Abstract
Utilizing 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT), we performed this pilot study to evaluate the link between cytogenetic/genomic markers and imaging patterns in relapsed/refractory (RR) multiple myeloma (MM). We retrospectively analyzed data of 24 patients with RRMM who were treated at our institution between November 2018 and February 2020. At the last relapse/progression, patients had been treated with a median of three (range 1–10) lines of therapy. Six (25%) patients showed FDG avid extramedullary disease without adjacency to bone. We observed significantly higher maximum standardized uptake values (SUVmax) in patients harboring del(17p) compared with those without del(17p) (p = 0.025). Moreover, a high SUVmax of >15 indicated significantly shortened progression-free survival (PFS) (p = 0.01) and overall survival (OS) (p = 0.0002). One female patient exhibited biallelic TP53 alteration, i.e., deletion and mutation, in whom an extremely high SUVmax of 37.88 was observed. In summary, this pilot study suggested a link between del(17p)/TP53 alteration and high SUVmax on 18F-FDG PET/CT in RRMM patients. Further investigations are highly warranted at this point.
Highlights
Multiple myeloma (MM) represents the second most common hematological malignancy in adults [1]
All 24 patients suffered from relapse or progression of MM at the time point of bone marrow biopsy and 18F-FDG-positron emission tomography (PET)/computed tomography (CT), which were performed prior to therapy initiation
To further elucidate the relationship between genomic alterations and imaging patterns, we reviewed the data of whole-genome sequencing (WGS) at the last relapse/progression, which were available in nine out of 24 patients
Summary
Multiple myeloma (MM) represents the second most common hematological malignancy in adults [1]. There are a few studies evaluating the association between cytogenetic abnormalities and imaging patterns in newly diagnosed MM (NDMM) Adverse cytogenetics, such as del(17p), gain(1q21), and t(4;14), have been reported to be enriched in NDMM patients with diffuse infiltration pattern in DWMRI C [4]. McDonald et al reported that total lesion glycolysis (TLG) >620 g and metabolic tumor volume (MTV) >210 cm indicated a significantly inferior progression-free survival (PFS) and overall survival (OS) of myeloma patients [6]. It has been less extensively investigated if imaging patterns of relapse and progression correlate with cytogenetic/genomic markers in RRMM. We performed this pilot study in RRMM utilizing 18F-FDG PET/CT
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
