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Comparison between neovascularization and cellular hypermetabolism in multiple myeloma using 68Ga-PSMA and 18F-FDG PET/CT imaging - a pilot study

Grant number: 18/00654-4
Support type:Regular Research Grants
Duration: November 01, 2018 - October 31, 2020
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Celso Darío Ramos
Grantee:Celso Darío Ramos
Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
Assoc. researchers:Allan de Oliveira Santos ; Camila Mosci ; Carmino Antonio de Souza ; Elba Cristina Sá de Camargo Etchebehere ; Fernando Vieira Pericole de Souza ; Irene Gyongyver Heidemarie Lorand Metze ; Mariana da Cunha Lopes de Lima ; Vânia Pereira de Castro Rodrigues


18F-FDG PET/CT has been used in the management of patients with multiple myeloma (MM) in staging, restaging and therapy assessment. Nevertheless, false negative results are reported mainly in patients with diffuse bone marrow infiltration or with lesions with low glycolyitc metabolic activity. This situation encourages search for more accurate positron emitters radiopharmaceuticals. On the other hand, with the development of new technologies based on multiparametric cytometry that are able to detect 0.001 percent of plasmocytes in bone marrow, both techniques have been considered in therapy assessment in MM. Recently, the radiopharmaceutical 68Ga-PSMA has been developed, theoretically a prostate specific membrane antigen used to detect prostate cancer lesions but it has been reported that this tracer is also an excellent neoangiogenesis marker that can be taken up by a variety of neoplasias besides prostate cancer. There are already reports of incidental finding of markedly increased 68Ga-PSMA uptake in multiple myeloma lesions. However, there are not prospective series in the literature evaluating the ability of 68Ga-PSMA PET/CT in detecting active multiple myeloma lesions. If this diagnostic ability could be comprovated and, eventually its superiority compared to 18F-FDG PET/CT imaging, 68Ga-PSMA PET/CT may contribute to improve accuracy of MM staging and to result in potential strategies alteration in disease management. Moreover, the demonstration of intense uptake of this radiopharmaceutical in MM patients may encourage the evaluation of a new therapeutic option for these patients, the radioisotopetherapy with 177Lu-PSMA or 225Ac-PSMA that showed very promissing results in patients with castrate-resistant metastatic prostate cancer. (AU)