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

Author(s):Show less -

Takahashi, Maria E. S. ^{[1, 2]} ; Mosci, Camila ^[3] ; Souza, Edna M. ^{[4, 3]} ; Brunetto, Sergio Q. ^{[4, 3]} ; Etchebehere, Elba ^[3] ; Santos, Allan O. ^[3] ; Camacho, Mariana R. ^{[2, 3]} ; Miranda, Eliana ^[5] ; Lima, Mariana C. L. ^[3] ; Amorim, Barbara J. ^[3] ; de Souza, Carmino ^{[2, 5]} ; Pericole, Fernando V. ^[5] ; Lorand-Metze, Irene ^{[2, 6]} ; Ramos, Celso D. ^{[2, 3]}

Affiliation

^[1] Univ Estadual Campinas, Gleb Wataghin Phys Inst, Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Sch Med Sci, Campinas, SP - Brazil

^[3] Univ Estadual Campinas, Div Nucl Med, Campinas, SP - Brazil

^[4] Univ Estadual Campinas, Ctr Biomed Engn, Campinas, SP - Brazil

^[5] Univ Estadual Campinas, Ctr Hematol & Hemotherapy, Campinas, SP - Brazil

^[6] Univ Estadual Campinas, Fac Med Sci, Dept Internal Med, Campinas, SP - Brazil

• Document type: Journal article
• Source: SCIENTIFIC REPORTS; v. 9, NOV 11 2019.
• Web of Science Citations: 0

Abstract

Many efforts have been made to standardize the interpretation of F-18-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 F-18-FDG PET/CT considering the extent and intensity of bone F-18-FDG uptake: Intensity of Bone Involvement (IBI). Whole body F-18-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 F-18-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. (AU)

• FAPESP's process: 18/00654-4 - Comparison between Neovascularization and Cellular Hypermetabolism in Multiple Myeloma Using 68Ga-PSMA and 18F-FDG PET/CT Imaging - A Pilot Study
• Grantee: Celso Darío Ramos
• Support Opportunities: Regular Research Grants
• FAPESP's process: 09/54065-0 - Acquisition of a PET/CT for the quantification of metabolic activity in living tissue
• Grantee: Carmino Antonio de Souza
• Support Opportunities: Multi-user Equipment Program