PET Imaging for Initial Staging and Therapy Assessment in Multiple Myeloma Patients

Abstract

Multiple myeloma (MM) is a hematological neoplasm characterized by the clonal proliferation of malignant plasma cells in the bone marrow. MM results in diffuse or focal bone infiltration and extramedullary lesions. Over the past two decades, advances have been made with regard to the diagnosis, staging, treatment, and imaging of MM. Computed tomography (CT) and magnetic resonance imaging (MRI) are currently recommended as the most effective imaging modalities at diagnostic. Yet, recent data from the literature suggest that positron emission tomography combined with computed tomography (PET/CT) using 18F-deoxyglucose (FDG) is a promising technique for initial staging and therapeutic monitoring in this pathology. This paper reviews the recent advances as well as the potential place of a more specific radiopharmaceutical in MM.

Comparison of Immuno-PET of CD138 and PET imaging with 64CuCl2 and 18F-FDG in a preclinical syngeneic model of multiple myeloma

“…Magnetic resonance imaging (MRI) is currently recommended as the most effective imaging for MM at diagnosis [ 2 ]. Positron emission tomography (PET) combined with computed tomography using [ 18 ]Fluorodeoxyglucose ( 18 F-FDG) is still being evaluated for initial staging and therapeutic monitoring in this pathology and its place needs to be validated [ 3 , 4 ]. However, 18 F-FDG being a non-tumor-specific metabolic tracer, development of phenotype tumor PET imaging is an attractive novel option to improve tumor characterization by targeting biomarkers expressed by neoplasm’s cells [ 5 ].…”

Interim PET Analysis in First-Line Therapy of Multiple Myeloma: Prognostic Value of ΔSUVmax in the FDG-Avid Patients of the IMAJEM Study

“…The last decade has seen the growing use of PET using 18 F-fluorodeoxyglucose (FDG-PET) for the staging and assessment of therapy in multiple myeloma (1,2). Several studies have shown the prognostic value of this imaging technique.…”

The Role of18F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

“…In 2006, the Durie–Salmon Plus (DS Plus) staging system integrated new imaging techniques, such as 18 F-2-fluoro-2-deoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI), into a new generation of MM staging and offered the opportunity to precisely stage patients by anatomic and functional techniques [ 8 ]. 18 F-FDG PET/CT provides prognostic information on symptomatic MM at the baseline and therapeutic follow-up, allowing the detection of extramedullary disease (EMD) [ 9 ]. However, no standard interpretation criteria have been proposed for the evaluation of 18 F-FDG PET/CT scans in MM, preventing reproducibility of data.…”