Multitracer PET/CT with [18F]Fluorodeoxiglucose and [18F]Fluorocholine in the Initial Staging of Multiple Myeloma Patients Applying the IMPeTus Criteria: A Pilot Study

Author:

Garrastachu Zumarán Puy12ORCID,García Megías Irene12,Mangas Losada María12,Mendoza Melero Alejandro12,Villanueva Torres Amós12,Boulvard Chollet Xavier12,Romero Robles Leonardo12,Hernández Pérez Prisma Montserrat3,Ramírez Lasanta Rafael12,Delgado Bolton Roberto C.12ORCID

Affiliation:

1. Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro, 26006 Logroño, Spain

2. Centre for Biomedical Research of La Rioja (CIBIR), Fundación Rioja Salud, 26006 Logroño, Spain

3. Department of Haematology, University Hospital San Pedro, 26006 Logroño, Spain

Abstract

Initial staging of patients diagnosed with multiple myeloma (MM) can lead to negative results using conventional diagnostic imaging workup, including [18F]Fluorodesoxiglucose ([18F]FDG) PET/CT. The aim of this prospective pilot study was to evaluate the diagnostic efficacy of [18F]Fluorocholine ([18F]FCH) PET/CT in the initial staging of MM patients who were candidates for autologous bone marrow transplant. Materials and Methods: The inclusion criteria of our study were: (a) patients diagnosed with MM; (b) candidates for autologous bone marrow transplant (AT); and (c) studied with [18F]FCH PET/CT and [18F]FDG PET/CT for initial staging less than 4 weeks apart. Imaging analysis included the presence of: bone marrow infiltration, focal bone lesions, and para-medullary or extra-medullary disease, according to the proposed IMPeTus criteria. The analysis was performed per lesion, per patient, and per location. Results: The study population included ten patients. Globally, [18F]FCH PET/CT showed bone marrow uptake in all the patients and visualised 16 more focal lesions than [18F]FDG PET/CT. One patient presented a plasmacytoma, detected by both tracers. Extra-medullary and para-medullary disease was identified with different degrees of uptake by both tracers. In summary, [18F]FCH PET seemed to be superior to [18F]FDG PET/CT in detecting focal bone lesions. SUVmax values were slightly higher in [18F]FCH PET/CT than in [18F]FDG PET/CT. Conclusions: Taking into account the small study population, according to our results, [18F]FCH PET/CT could be a useful tool for staging MM patients.

Funder

Operational Program of the European Regional Development Fund

Publisher

MDPI AG

Subject

Clinical Biochemistry

Reference42 articles.

1. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma;Rajkumar;Lancet Oncol.,2014

2. 18F-FDG versus Non-FDG PET tracers in multiple myeloma;Hemrom;PET Clin.,2022

3. Cancer statistics, 2018;Siegel;CA Cancer J. Clin.,2018

4. (2023, January 05). Myeloma—CancerStatFacts. SEER, Available online: https://seer.cancer.gov/statfacts/html/mulmy.html.

5. Grupo Español de Mieloma (2021). Guía de Mieloma Múltiple, Luzan 5.

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