Τίτλος:
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
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Paschali, A.
Panagiotidis, E.
Triantafyllou, T.
Palaska, V.
Tsirou, K.
Verrou, E.
Υiannaki, E.
Markala, D.
Papanikolaou, A.
Pouli, A.
Konstantinidou, P.
Chatzipavlidou, V.
Terpos, E.
Katodritou, E.
Περιοδικό:
European Journal of Nuclear Medicine and Molecular Imaging
Εκδότης:
Springer Science and Business Media Deutschland GmbH
Λέξεις-κλειδιά:
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
DOI:
10.1007/s00259-020-05078-1
