18F-fluoro-ethyl-tyrosine (18F-FET) PET/CT as a potential new diagnostic tool in multiple myeloma: a preliminary study

Czyż, Jarosław; Małkowski, Bogdan; Jurczyszyn, Artur; Grząśko, Norbert; Łopatto, Rita; Olejniczak, Monika; Czyż, Adriana; Jachalska, Anna

doi:10.5114/wo.2019.83342

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…An alternative AA tracer for MM imaging is [ 18 F]-FET which also showed high tumor uptake in our preclinical studies as well as in a recent clinical trial [ 8 ]. Tumor uptake of [ 18 F]-FET was, however, significantly lower than of [ 18 F]-FACBC in our preclinical study.…”

Section: Discussionmentioning

confidence: 99%

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Initial evaluation of [18F]-FACBC for PET imaging of multiple myeloma

et al. 2022

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Rationale Multiple myeloma (MM) cells synthesize large amounts of paraproteins, making radiolabeled amino acids promising candidates for PET imaging of MM patients. Methods We compare tumor uptake of the two amino acid analogs [18F]-fluoroethyltyrosine and [18F]-FACBC in a MM xenograft model and show the feasibility of PET imaging with [18F]-FACBC in a MM patient. Results Preclinically [18F]-FACBC showed superior performance, mainly due to the uptake via the ASC-system. In a subsequent proof-of-concept investigation [18F]-FACBC PET was performed in a MM patient. It allowed identification of both lesions with and without CT correlate (SUVmean 8.0 or 7.9) based on higher uptake compared to normal bone marrow (SUVmean 5.7). Bone signal was elevated compared to non-MM patients, and, thus [18F]-FACBC potentially allows the assessment of bone marrow infiltration. Conclusion The FDA/EMA approved PET agent [18F]-FACBC is promising for imaging MM and should be further evaluated in prospective clinical studies.

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Section: Discussionmentioning

confidence: 99%

“…For the AA analogue [ 18 F]-fluorethlytyrosine (FET) conflicting preclinical data about its uptake in MM cells have been reported [ 6 , 7 ]. However, a recent clinical study reported high uptake of FET by MM and excellent image contrast [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Initial evaluation of [18F]-FACBC for PET imaging of multiple myeloma

et al. 2022

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“…The methodology described here could potentially be adapted to compare different radiotracers recently proposed for evaluating MM, such as 11 C-choline 34 , 11 C-methionine 34 , 18 F-fluoro-ethyl-tyrosine 35 , 68 Ga-DOTATATE 36 and 68 Ga-PSMA 37 . MM lesions frequently present varying degrees of uptake of those radiotracers compared to FDG uptake 35,36 , probably due to the extensive intra and inter-patient genomic heterogeneity of the disease 38 . An objective quantitative comparison of those tracers in MM might be of interest.…”

Section: Discussionmentioning

confidence: 99%

Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma

Takahashi

Mosci

Souza

et al. 2019

Sci Rep

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Many efforts have been made to standardize the interpretation of 18 f-fDG pet/ct in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18 F-FDG PET/CT considering the extent and intensity of bone 18 F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18 F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18 F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement -PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00-1.35). Visual analysis categorized PET exams into three groups (negative/ mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients' hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.Lytic bone lesions are reported in approximately 80% of myeloma multiple (MM) patients 1,2 . Early and precise evaluation of bone involvement is crucial for staging and correct disease management.Hybrid image of positron emission tomography with 18 F-fluordeoxyglucose and computed tomography ( 18 F-FDG PET/CT) is one of the main methods for the evaluation of MM patients. It allows whole-body images, intra and extramedullary lesion detection, distinction between active lesions and scar or necrotic tissue and has been more sensitive than MRI in treatment assessment 3-5 .Many efforts have been attempted to standardize the interpretation of 18 F-FDG PET/CT in MM, using qualitative visual analysis or quantitative metabolic parameters, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) 6-9 . However, none of these methods have been extensively used in clinical practice or research projects, probably because of the complexity of the visual quantification 6,7 or due to the lack of standardization of MTV and TLG calculations 8-10 . Also, MTV and TLG only consider areas visually defined as lesions and ignore diffuse uptake of the bone marrow.

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“…A clinical study found sensitivity and specificity values of 55.58 and 9.09%, respectively, for 18 F-FET PET/CT assessment. Thus, 18 F-FET does not seem to be a promising biomarker in myeloma imaging (39).…”

Section: Clinical Value Of 11 C-met-pet In MMmentioning

confidence: 95%

Amino Acid and Proliferation PET/CT for the Diagnosis of Multiple Myeloma

Minamimoto

2022

Front. Nucl. Med.

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Multiple myeloma (MM) is a hematologic malignancy characterized by infiltration of monoclonal plasma cells in the bone marrow (BM). The standard examination performed for the assessment of bone lesions has progressed from radiographic skeletal survey to the more advanced imaging modalities of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT). The Durie–Salmon PLUS staging system (upgraded from the Durie–Salmon staging system) applies 2-[18F]-fluoro-2-deoxy-glucose (18F-FDG) PET/CT, and MRI findings to the staging of MM, and 18F-FDG PET/CT has been incorporated into the International Myeloma Working Group (IMWG) guidelines for the diagnosis and staging of MM. However, 18F-FDG PET/CT has significant limitations in the assessment of diffuse BM infiltration and in the differentiation of MM lesions from inflammatory or infectious lesions. The potential of several new PET tracers that exploit the underlying disease mechanism of MM has been evaluated in terms of improving the diagnosis. L-type amino acid transporter 1 (LAT1), a membrane protein that transports neutral amino acids, is associated with cell proliferation and has strong ability to represent the status of MM. This review evaluates the potential of amino acid and proliferation PET tracers for diagnosis and compares the characteristics and accuracy of non-FDG tracers in the management of patients with MM.

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18F-fluoro-ethyl-tyrosine (18F-FET) PET/CT as a potential new diagnostic tool in multiple myeloma: a preliminary study

Cited by 13 publications

References 26 publications

Initial evaluation of [18F]-FACBC for PET imaging of multiple myeloma

Initial evaluation of [18F]-FACBC for PET imaging of multiple myeloma

Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma

Amino Acid and Proliferation PET/CT for the Diagnosis of Multiple Myeloma

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