TY - JOUR
TI - A proposed index of diffuse bone marrow [18F]-FDG uptake and PET skeletal patterns correlate with myeloma prognostic markers, plasma cell morphology, and response to therapy
AU - Paschali, A.
AU - Panagiotidis, E.
AU - Triantafyllou, T.
AU - Palaska, V.
AU - Tsirou, K.
AU - Verrou, E.
AU - Υiannaki, E.
AU - Markala, D.
AU - Papanikolaou, A.
AU - Pouli, A.
AU - Konstantinidou, P.
AU - Chatzipavlidou, V.
AU - Terpos, E.
AU - Katodritou, E.
JO - European Journal of Nuclear Medicine and Molecular Imaging
PY - 2021
VL - 48
TODO - 5
SP - 1487-1497
PB - Springer Science and Business Media Deutschland GmbH
SN - 1619-7070, 1619-7089
TODO - 10.1007/s00259-020-05078-1
TODO - albumin;  beta 2 microglobulin;  calcium;  creatinine;  ferritin;  fluorodeoxyglucose f 18;  hemoglobin;  immunoglobulin A;  immunoglobulin D;  immunoglobulin G;  immunoglobulin light chain;  immunoglobulin M;  lactate dehydrogenase;  proteasome inhibitor;  fluorodeoxyglucose f 18;  radiopharmaceutical agent, adult;  aged;  albumin blood level;  appendicular skeleton;  Article;  bone marrow;  bone marrow biopsy;  calcium blood level;  cancer prognosis;  cancer recurrence;  cell infiltration;  cell structure;  creatinine blood level;  cytogenetics;  diagnostic accuracy;  diagnostic value;  disease marker;  estimated glomerular filtration rate;  female;  ferritin blood level;  fluorescence in situ hybridization;  human;  International Staging System;  major clinical study;  male;  maximum standardized uptake value;  metabolism;  multiple myeloma;  overall response rate;  pelvis liver ratio;  plasma cell;  positron emission tomography-computed tomography;  prospective study;  sensitivity and specificity;  thrombocyte;  treatment response;  tumor differentiation;  bone marrow;  diagnostic imaging;  multiple myeloma;  positron emission tomography-computed tomography;  prognosis;  retrospective study, Bone Marrow;  Fluorodeoxyglucose F18;  Humans;  Multiple Myeloma;  Plasma Cells;  Positron Emission Tomography Computed Tomography;  Prognosis;  Radiopharmaceuticals;  Retrospective Studies
TODO - Purpose: The investigation of a semi-quantitative index in the pelvis to assess for diffuse bone marrow (BM) [18F]-FDG uptake and the investigation of PET skeletal patterns in multiple myeloma (MM) patients, in accordance with prognostic markers, clonal plasma cell (cPC) morphology, and response to therapy. Methods: We prospectively analyzed [18F]-FDG PET/CT in 90 MM patients (newly diagnosed, 60; relapsed/refractory, 30). Among other PET/CT parameters, we calculated the ratio SUVmax pelvis/liver and examined for correlations with known MM prognostic parameters, cPC morphology (good vs. low/intermediate differentiation), and response to therapy. Results: SUVmax pelvis/liver ratio was significantly lower for the group of good differentiation vs. intermediate/low differentiation cPCs (p < 0.001) and showed a positive correlation with BM infiltration rate, β2 microglobulin, serum ferritin, international staging system (ISS), and revised ISS; no significant correlation was found with hemoglobin. A cutoff value of 1.1 showed an excellent specificity (99%) and high sensitivity (76%) for diffuse BM involvement (AUC 0.94; p < 0.001). Mixed pattern and appendicular involvement correlated with poor prognostic features while normal pattern, found in 30% of patients, correlated with good prognostic features. Presence of ≥ 10 focal lesions negatively predicted for overall response (p < 0.05; OR 4.8). The CT component improved the diagnostic performance of PET. Conclusion: This study showed, for the first time, that cPC morphology and markers related with MM biology, correlate with SUVmax pelvis/liver index, which could be used as a surrogate marker for BM assessment and disease prognosis; PET patterns correlate with MM prognostic features and response rates. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
ER -