Clinical Value of FDG-PET/CT in Multiple Myeloma: An Update

Molecular imaging of bone metastasis

“…A recent review by Bezzi et al [ 45 ] evaluated the prognostic value of 18 F-FDG-PET/CT in evaluating treatment response and minimal residual disease (MRD), and the possible implications of 18 F-FDG-PET/CT in recurrence. Some of the key highlights of this article are: (1) Higher SUV max , more focal bone lesions and extramedullary disease were associated with poor overall survival (OS) and progression-free survival (PFS), (2) Molecular imaging can assist with stratification of patients with stage II and unfavorable prognosis for newer therapies such as immunotherapies, (3) Presence of paramedullary disease [identified by imaging] is associated with lower level of PFS, (4) There is a need for better refinement of PET-quantitative measures such as better thresholding for assessing metabolic tumor volume, (5) There is value in incorporating imaging data together with molecular analyses (such as cfDNA, cpDNA), (6) Normalization of PET/CT after induction and pre-maintenance are positive prognostic factors for PFS and OS, (7) There is complementarity between PET and bone marrow MRD techniques (such as multiparametric flow cytometry approaches, the next generation flow and next generation sequencing) and concordant negativity should be evaluated as a surrogate for outcome prediction.…”

18F-Fluorodeoxyglucose-Avid Benign Anthracotic Mediastinal Lymphadenitis Mimicking Metastatic Lymphadenopathy

“…Due to its high contrast lesion-to-background ratio, it is recommended for evaluating non-small cell lung carcinoma (NSCLC), as well as head, neck, and esophageal cancers [1,2]. FDG PET/CT also plays a prognostic role in hematologic malignancies like leukemia, lymphoma, and multiple myeloma, where lymph node involvement is prevalent [3][4][5][6]. Apart from primary lymphoid malignancies and metastasis, benign conditions can also present with FDG-avid mediastinal and abdominal lymphadenopathy, mimicking metastatic lymph nodes in patients with concomitant malignancies.…”