THE ROLE OF THE UPTAKE PATTERN OF 18F-FDG PET/CT AND 99MTC-MIBI IN THE DIAGNOSTIC EVALUATION OF PATIENTS WITH MULTIPLE MYELOMA.
(Abstract release date: 05/21/15)
EHA Library. Metze I. 06/12/15; 102794; PB1894
Disclosure(s): University of CampinasInternal Medicine
Irene G. H. Lorand Metze
Contributions
Contributions
Abstract
Abstract: PB1894
Type: Publication Only
Background
for staging of myeloma it is important not only to measure the total tumor mass but also to localize the lesions in order to treat special localizations
Aims
to compare the image patterns of 18F-FDG positron emission computed tomography/ computed tomography (PET/CT) with those of 99mTc-MIBI single photon emission tomography/CT (SPECT/CT) at diagnosis in plasma cell neoplasms (MM) and evaluate the relation of this pattern with risk factors, therapy response and patients' progression-free survival (PFS).
Methods
Eighteen newly diagnosed MM patients were enrolled. PET/CT and SPECT/CT were included in the diagnostic work-up, reporting focal lesions and diffuse bone marrow involvement. One patient had a solitary plasmacytoma and was not evaluated for response. Patients gave informed consent.
Results
Eleven patients (61%) were male. Median age: 57 years (37-84); albumin 3.4 g/dL (2.16-4.2), beta-2-microglobulin: 4.2 mg/L (0.4-29.4), calcium 9.8 mg/dL (7.8-15), serum creatinine 0.85 mg/dL (0.6-2.4). No patient was on dialysis. According to ISS, 2 patients were stage I; 6 were stage II, and 10 were stage III. One case fulfilled criteria for plasma cell leukemia and 1 had a solitary plasmocytoma. Patients received CTD (12 patients); MPT (3 patients); CVD and Dexa-Tal (one case each). PET/CT and SPECT/CT, were concordant for presence (11) or absence (4) of a diffuse pattern. In the last ones, two showed positive foci in PET/CT. PET was able to detect >84 (extramedullary in six cases) while SPECT/CT detected only 10 focal lesions (extramedullary in one case). Intensity of 99mTc-MIBI uptake as well as the number of foci seen in PET/CT had an inverse correlation with hemoglobin values but not with ISS. A very good partial remission was seen in 5 patients and 2 had a complete remission. After a median follow-up of 12 months (1-19), 4 patients had progressed and 3 patients (17.6%) died during the follow-up. The 12 month progression free survival for diffuse pattern of PET/CT and SPECT/CT was not statistically different, although none of the patients with a negative SPECT/CT had progressed.
Summary
in this preliminary study, 18F-FDG PET/CT detected more focal lesions (including extramedullary lesions) and 99mTc-MIBI was able to measure the intensity of diffuse BM involvement. Both techniques should be used together, especially in clinical studies, as they give complementary information. Concerning therapy response, the time of observation is rather short, and no relation with PFS and OS was found yet.
Keyword(s): Multiple myeloma, PET, Prognostic factor, Staging
Session topic: Publication Only
Type: Publication Only
Background
for staging of myeloma it is important not only to measure the total tumor mass but also to localize the lesions in order to treat special localizations
Aims
to compare the image patterns of 18F-FDG positron emission computed tomography/ computed tomography (PET/CT) with those of 99mTc-MIBI single photon emission tomography/CT (SPECT/CT) at diagnosis in plasma cell neoplasms (MM) and evaluate the relation of this pattern with risk factors, therapy response and patients' progression-free survival (PFS).
Methods
Eighteen newly diagnosed MM patients were enrolled. PET/CT and SPECT/CT were included in the diagnostic work-up, reporting focal lesions and diffuse bone marrow involvement. One patient had a solitary plasmacytoma and was not evaluated for response. Patients gave informed consent.
Results
Eleven patients (61%) were male. Median age: 57 years (37-84); albumin 3.4 g/dL (2.16-4.2), beta-2-microglobulin: 4.2 mg/L (0.4-29.4), calcium 9.8 mg/dL (7.8-15), serum creatinine 0.85 mg/dL (0.6-2.4). No patient was on dialysis. According to ISS, 2 patients were stage I; 6 were stage II, and 10 were stage III. One case fulfilled criteria for plasma cell leukemia and 1 had a solitary plasmocytoma. Patients received CTD (12 patients); MPT (3 patients); CVD and Dexa-Tal (one case each). PET/CT and SPECT/CT, were concordant for presence (11) or absence (4) of a diffuse pattern. In the last ones, two showed positive foci in PET/CT. PET was able to detect >84 (extramedullary in six cases) while SPECT/CT detected only 10 focal lesions (extramedullary in one case). Intensity of 99mTc-MIBI uptake as well as the number of foci seen in PET/CT had an inverse correlation with hemoglobin values but not with ISS. A very good partial remission was seen in 5 patients and 2 had a complete remission. After a median follow-up of 12 months (1-19), 4 patients had progressed and 3 patients (17.6%) died during the follow-up. The 12 month progression free survival for diffuse pattern of PET/CT and SPECT/CT was not statistically different, although none of the patients with a negative SPECT/CT had progressed.
Summary
in this preliminary study, 18F-FDG PET/CT detected more focal lesions (including extramedullary lesions) and 99mTc-MIBI was able to measure the intensity of diffuse BM involvement. Both techniques should be used together, especially in clinical studies, as they give complementary information. Concerning therapy response, the time of observation is rather short, and no relation with PFS and OS was found yet.
Keyword(s): Multiple myeloma, PET, Prognostic factor, Staging
Session topic: Publication Only
Abstract: PB1894
Type: Publication Only
Background
for staging of myeloma it is important not only to measure the total tumor mass but also to localize the lesions in order to treat special localizations
Aims
to compare the image patterns of 18F-FDG positron emission computed tomography/ computed tomography (PET/CT) with those of 99mTc-MIBI single photon emission tomography/CT (SPECT/CT) at diagnosis in plasma cell neoplasms (MM) and evaluate the relation of this pattern with risk factors, therapy response and patients' progression-free survival (PFS).
Methods
Eighteen newly diagnosed MM patients were enrolled. PET/CT and SPECT/CT were included in the diagnostic work-up, reporting focal lesions and diffuse bone marrow involvement. One patient had a solitary plasmacytoma and was not evaluated for response. Patients gave informed consent.
Results
Eleven patients (61%) were male. Median age: 57 years (37-84); albumin 3.4 g/dL (2.16-4.2), beta-2-microglobulin: 4.2 mg/L (0.4-29.4), calcium 9.8 mg/dL (7.8-15), serum creatinine 0.85 mg/dL (0.6-2.4). No patient was on dialysis. According to ISS, 2 patients were stage I; 6 were stage II, and 10 were stage III. One case fulfilled criteria for plasma cell leukemia and 1 had a solitary plasmocytoma. Patients received CTD (12 patients); MPT (3 patients); CVD and Dexa-Tal (one case each). PET/CT and SPECT/CT, were concordant for presence (11) or absence (4) of a diffuse pattern. In the last ones, two showed positive foci in PET/CT. PET was able to detect >84 (extramedullary in six cases) while SPECT/CT detected only 10 focal lesions (extramedullary in one case). Intensity of 99mTc-MIBI uptake as well as the number of foci seen in PET/CT had an inverse correlation with hemoglobin values but not with ISS. A very good partial remission was seen in 5 patients and 2 had a complete remission. After a median follow-up of 12 months (1-19), 4 patients had progressed and 3 patients (17.6%) died during the follow-up. The 12 month progression free survival for diffuse pattern of PET/CT and SPECT/CT was not statistically different, although none of the patients with a negative SPECT/CT had progressed.
Summary
in this preliminary study, 18F-FDG PET/CT detected more focal lesions (including extramedullary lesions) and 99mTc-MIBI was able to measure the intensity of diffuse BM involvement. Both techniques should be used together, especially in clinical studies, as they give complementary information. Concerning therapy response, the time of observation is rather short, and no relation with PFS and OS was found yet.
Keyword(s): Multiple myeloma, PET, Prognostic factor, Staging
Session topic: Publication Only
Type: Publication Only
Background
for staging of myeloma it is important not only to measure the total tumor mass but also to localize the lesions in order to treat special localizations
Aims
to compare the image patterns of 18F-FDG positron emission computed tomography/ computed tomography (PET/CT) with those of 99mTc-MIBI single photon emission tomography/CT (SPECT/CT) at diagnosis in plasma cell neoplasms (MM) and evaluate the relation of this pattern with risk factors, therapy response and patients' progression-free survival (PFS).
Methods
Eighteen newly diagnosed MM patients were enrolled. PET/CT and SPECT/CT were included in the diagnostic work-up, reporting focal lesions and diffuse bone marrow involvement. One patient had a solitary plasmacytoma and was not evaluated for response. Patients gave informed consent.
Results
Eleven patients (61%) were male. Median age: 57 years (37-84); albumin 3.4 g/dL (2.16-4.2), beta-2-microglobulin: 4.2 mg/L (0.4-29.4), calcium 9.8 mg/dL (7.8-15), serum creatinine 0.85 mg/dL (0.6-2.4). No patient was on dialysis. According to ISS, 2 patients were stage I; 6 were stage II, and 10 were stage III. One case fulfilled criteria for plasma cell leukemia and 1 had a solitary plasmocytoma. Patients received CTD (12 patients); MPT (3 patients); CVD and Dexa-Tal (one case each). PET/CT and SPECT/CT, were concordant for presence (11) or absence (4) of a diffuse pattern. In the last ones, two showed positive foci in PET/CT. PET was able to detect >84 (extramedullary in six cases) while SPECT/CT detected only 10 focal lesions (extramedullary in one case). Intensity of 99mTc-MIBI uptake as well as the number of foci seen in PET/CT had an inverse correlation with hemoglobin values but not with ISS. A very good partial remission was seen in 5 patients and 2 had a complete remission. After a median follow-up of 12 months (1-19), 4 patients had progressed and 3 patients (17.6%) died during the follow-up. The 12 month progression free survival for diffuse pattern of PET/CT and SPECT/CT was not statistically different, although none of the patients with a negative SPECT/CT had progressed.
Summary
in this preliminary study, 18F-FDG PET/CT detected more focal lesions (including extramedullary lesions) and 99mTc-MIBI was able to measure the intensity of diffuse BM involvement. Both techniques should be used together, especially in clinical studies, as they give complementary information. Concerning therapy response, the time of observation is rather short, and no relation with PFS and OS was found yet.
Keyword(s): Multiple myeloma, PET, Prognostic factor, Staging
Session topic: Publication Only
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