Intensity of bone involvement: a quantitative F-18-FDG PET/CT evaluation for monitoring outcome of multiple myeloma

Author(s)

Takahashi, Maria Emilia Seren ^[1] ; Mosci, Camila ^[2] ; Duarte, Gislaine O. ^[3] ; Pericole, Fernando V. ^[3] ; Metze, Konradin ^[4] ; Lorand-Metze, Irene G. H. ^[5] ; Ramos, Celso D. ^[2]

Affiliation

^[1] Univ Campinas UNICAMP, Gleb Wataghin Inst Phys, R Sergio Buarque Holanda 777, Cidade Univ, BR-13083859 Campinas - Brazil

^[2] Univ Campinas UNICAMP, Div Nucl Med, Sch Med Sci, Campinas - Brazil

^[3] Univ Campinas UNICAMP, Ctr Hematol & Hemotherapy, Campinas - Brazil

^[4] Univ Campinas UNICAMP, Dept Pathol, Sch Med Sci, Campinas - Brazil

^[5] Univ Campinas UNICAMP, Dept Internal Med, Campinas - Brazil

• Document type: Journal article
• Source: NUCLEAR MEDICINE COMMUNICATIONS; v. 42, n. 12, p. 1375-1381, DEC 2021.
• Web of Science Citations: 0

Abstract

Purpose The parameter intensity of bone involvement (IBI) was recently proposed to quantitatively assess patients with multiple myeloma using F-18-fluorodeoxyglucose-PET combined with computed tomography (F-18-FDG PET/CT) images. Here, we aimed to calculate IBI variation (Delta IBI) between two consecutive PET/CT of the same patient and verified its relationship with a subjective visual analysis of the images and with clinical outcome. Methods Consecutive whole-body F-18-FDG PET/CT performed to assess the outcomes of 29 patients diagnosed with multiple myeloma were retrospectively evaluated. Delta IBI was calculated after bone segmentation, using liver standardized uptake value as a threshold to determine metabolically active volumes in the skeleton. For each pair of consecutive PET/CTs, two nuclear medicine physicians classified visually the most recent image as PET-remission, PET-progression or PET-stable when compared to the previous examination. Results The lowest Delta IBI was -1.27 and the highest was 0.29. PET-remission was related to Delta IBI <0 (median = -0.10; -1.27 to +0.03), while PET-progression was related to Delta IBI >0 (median = 0.02; -0.07 to +0.29). Delta IBI around zero was found in images classified as PET-stable (median = 0.00; -0.08 to +0.06). Significant difference in Delta IBI was found between the three groups. Multivariate stepwise analysis showed that IBI value at diagnostic PET/CT, serum calcium and percentage of plasma cells in the bone marrow are independent prognostic factors. Conclusion Delta IBI provides quantitative data for variations of F-18-FDG uptake in the bone marrow during the follow-up of the patients. In addition, higher IBI values at diagnosis are associated with a higher risk of patient's death. (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