Metabolic Volume Measurements in Multiple Myeloma

Author(s)

Takahashi, Maria Emilia Seren ^[1] ; Lorand-Metze, Irene ^[2] ; de Souza, Carmino Antonio ^[3] ; Mesquita, Claudio Tinoco ^{[4, 5]} ; Fernandes, Fernando Amorim ^[5] ; Carvalheira, Jose Barreto Campello ^[6] ; Ramos, Celso Dario ^[7]

Affiliation

^[1] Univ Campinas UNICAMP, Gleb Wataghin Inst Phys, BR-13083859 Campinas - Brazil

^[2] Univ Campinas UNICAMP, Fac Med Sci, Dept Internal Med, BR-13083888 Campinas - Brazil

^[3] Univ Campinas UNICAMP, Ctr Hematol & Hemotherapy, BR-13083878 Campinas - Brazil

^[4] Univ Fed Fluminense UFF, Fac Med, Dept Radiol, BR-24033900 Niteroi, RJ - Brazil

^[5] Univ Fed Fluminense UFF, Hosp Univ Antonio Pedro, EBSERH, BR-24033900 Niteroi, RJ - Brazil

^[6] Univ Campinas UNICAMP, Sch Med Sci, Div Oncol, BR-13083888 Campinas - Brazil

^[7] Univ Campinas UNICAMP, Sch Med Sci, Div Nucl Med, BR-13083888 Campinas - Brazil

• Document type: Journal article
• Source: METABOLITES; v. 11, n. 12 DEC 2021.
• Web of Science Citations: 0

Abstract

Multiple myeloma (MM) accounts for 10-15% of all hematologic malignancies, as well as 20% of deaths related to hematologic malignant tumors, predominantly affecting bone and bone marrow. Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) is an important method to assess the tumor burden of these patients. It is often challenging to classify the extent of disease involvement in the PET scans for many of these patients because both focal and diffuse bone lesions may coexist, with varying degrees of FDG uptake. Different metrics involving volumetric parameters and texture features have been proposed to objectively assess these images. Here, we review some metabolic parameters that can be extracted from FDG-PET/CT images of MM patients, including technical aspects and predicting MM outcome impact. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters known to be independent predictors of MM outcome. However, they have not been adopted in clinical practice due to the lack of measuring standards. CT-based segmentation allows automated, and therefore reproducible, calculation of bone metabolic metrics in patients with MM, such as maximum, mean and standard deviation of the standardized uptake values (SUV) for the entire skeleton. Intensity of bone involvement (IBI) is a new parameter that also takes advantage of this approach with promising results. Other indirect parameters obtained from FDG-PET/CT images, such as visceral adipose tissue glucose uptake and subcutaneous adipose tissue radiodensity, may also be useful to evaluate the prognosis of MM patients. Furthermore, the use and quantification of new radiotracers can address different metabolic aspects of MM and may have important prognostic implications. (AU)

• FAPESP's process: 21/03421-3 - Inflammatory and functional imaging aspects of COVID-19: analysis of PET/CT and pulmonary perfusion scintigraphy imaging findings
• Grantee: Celso Darío Ramos
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/14132-0 - EANM'18 - Annual Congress of the European AssociaBon of Nuclear Medicine
• Grantee: Celso Darío Ramos
• Support Opportunities: Research Grants - Meeting - Abroad