FDG-PET/CT IN MULTIPLE MYELOMA A CORRELATION OF SUV AND ISS SCORE
(Abstract release date: 05/19/16)
EHA Library. Østergaard B. 06/09/16; 134870; PB1970
Mr. Brian Østergaard
Contributions
Contributions
Abstract
Abstract: PB1970
Type: Publication Only
Background
FDG-PET/CT is a promising methodology for staging, prognostication and response evaluation in multiple myeloma (MM). High intensity of FDG uptake measured as SUV (standard uptake value) at diagnosis is associated to more aggressive disease and reduced overall survival1,2 However, it is unknown if the informative value is independent of other prognostic markers.1) Bartel, T. B., et al. Blood 114.10 (2009): 2068-76.2) Zamagni, E., et al. Blood 118.23 (2011): 5989-95.
Aims
We aimed to investigate the association of the intensity of FDG uptake in the most intense focal lesions and established prognostic markers in MM, including ISS and revised ISS (R-ISS).
Methods
As a part of a prospective study3 with evaluation of new imaging technologies in MM we explored the first 35 included patients with treatment demanding MM. Patients were enrolled at diagnosis and studied with standardized baseline 18F-FDG-PET/CT prior to any given anti-myeloma treatment. Patients that had received steroids or bisphosphonates were excluded. Two experienced specialists, a nuclear medicine specialist (ANL) and a radiologist (JTA) evaluated the PET/CT. The lesion with the highest FDG uptake was described by a semi quantitative software ROVER for the values of lesion volume, SUVmax, SUVpeak, SUVmean and SUVmeancorr (SUVmean corrected for partial volume effects). Finally SUVmax was standardized to liver according to the Deauville criteria. Quantitative values were tested for correlation to prognostic indices ISS and revised ISS (R-ISS) using Kruskall Wallis test and Fischers exact test. STATA14 was used for analyses.3) ClinicalTrials.cov. ID: NCT02187731
Results
One patient had incomplete ISS data. Thus 34 patients were included in the analysis. 19, 11 and 4 patients were stratified into ISS group I, II and III, respectively. 9, 24 and 1 patient were stratified into the revised ISS group R-ISS1, R-ISS2 and R-ISS3, respectively. SUVmax values were between 3.6Mbq/ml and 27.8Mbq/ml and lesion volumes between 0.9ml and 216ml. 6 patients had Deauville score 3, and 12 Deauville score 4, and 6 patients had Deauville score 5. FDG uptake (SUVmax) standardized to liver showed correlation to ISS (p=0.03) but not the R-ISS (p=0.85). Absolute SUVmax, SUVpeak, SUVmean, SUVmeancorr were not correlated to neither ISS nor R-ISS (p values (0.3-0.8).
Conclusion
34 newly diagnosed MM patients were tested for association between FDG uptake values and the prognostic indices ISS and R-ISS. Only a marginal significant association between FDG uptake standardized to liver according to the Deauville criteria and ISS was observed. The use of FDG uptake values standardized to liver compensate for the general metabolic activity in the body and may therefore be more informative than absolute SUV values. Our cohort does not show a strong association between FDG SUV values and ISS or R-ISS, which may indicate that FDG PET offers prognostic information independent of R-ISS. At the meeting we will present an extended cohort. The association between FDG uptake values and prognostic factors in MM warrants further studies.
Session topic: E-poster
Keyword(s): FDG-PET, International prognostic index, Multiple myeloma
Type: Publication Only
Background
FDG-PET/CT is a promising methodology for staging, prognostication and response evaluation in multiple myeloma (MM). High intensity of FDG uptake measured as SUV (standard uptake value) at diagnosis is associated to more aggressive disease and reduced overall survival1,2 However, it is unknown if the informative value is independent of other prognostic markers.1) Bartel, T. B., et al. Blood 114.10 (2009): 2068-76.2) Zamagni, E., et al. Blood 118.23 (2011): 5989-95.
Aims
We aimed to investigate the association of the intensity of FDG uptake in the most intense focal lesions and established prognostic markers in MM, including ISS and revised ISS (R-ISS).
Methods
As a part of a prospective study3 with evaluation of new imaging technologies in MM we explored the first 35 included patients with treatment demanding MM. Patients were enrolled at diagnosis and studied with standardized baseline 18F-FDG-PET/CT prior to any given anti-myeloma treatment. Patients that had received steroids or bisphosphonates were excluded. Two experienced specialists, a nuclear medicine specialist (ANL) and a radiologist (JTA) evaluated the PET/CT. The lesion with the highest FDG uptake was described by a semi quantitative software ROVER for the values of lesion volume, SUVmax, SUVpeak, SUVmean and SUVmeancorr (SUVmean corrected for partial volume effects). Finally SUVmax was standardized to liver according to the Deauville criteria. Quantitative values were tested for correlation to prognostic indices ISS and revised ISS (R-ISS) using Kruskall Wallis test and Fischers exact test. STATA14 was used for analyses.3) ClinicalTrials.cov. ID: NCT02187731
Results
One patient had incomplete ISS data. Thus 34 patients were included in the analysis. 19, 11 and 4 patients were stratified into ISS group I, II and III, respectively. 9, 24 and 1 patient were stratified into the revised ISS group R-ISS1, R-ISS2 and R-ISS3, respectively. SUVmax values were between 3.6Mbq/ml and 27.8Mbq/ml and lesion volumes between 0.9ml and 216ml. 6 patients had Deauville score 3, and 12 Deauville score 4, and 6 patients had Deauville score 5. FDG uptake (SUVmax) standardized to liver showed correlation to ISS (p=0.03) but not the R-ISS (p=0.85). Absolute SUVmax, SUVpeak, SUVmean, SUVmeancorr were not correlated to neither ISS nor R-ISS (p values (0.3-0.8).
Conclusion
34 newly diagnosed MM patients were tested for association between FDG uptake values and the prognostic indices ISS and R-ISS. Only a marginal significant association between FDG uptake standardized to liver according to the Deauville criteria and ISS was observed. The use of FDG uptake values standardized to liver compensate for the general metabolic activity in the body and may therefore be more informative than absolute SUV values. Our cohort does not show a strong association between FDG SUV values and ISS or R-ISS, which may indicate that FDG PET offers prognostic information independent of R-ISS. At the meeting we will present an extended cohort. The association between FDG uptake values and prognostic factors in MM warrants further studies.
Session topic: E-poster
Keyword(s): FDG-PET, International prognostic index, Multiple myeloma
Abstract: PB1970
Type: Publication Only
Background
FDG-PET/CT is a promising methodology for staging, prognostication and response evaluation in multiple myeloma (MM). High intensity of FDG uptake measured as SUV (standard uptake value) at diagnosis is associated to more aggressive disease and reduced overall survival1,2 However, it is unknown if the informative value is independent of other prognostic markers.1) Bartel, T. B., et al. Blood 114.10 (2009): 2068-76.2) Zamagni, E., et al. Blood 118.23 (2011): 5989-95.
Aims
We aimed to investigate the association of the intensity of FDG uptake in the most intense focal lesions and established prognostic markers in MM, including ISS and revised ISS (R-ISS).
Methods
As a part of a prospective study3 with evaluation of new imaging technologies in MM we explored the first 35 included patients with treatment demanding MM. Patients were enrolled at diagnosis and studied with standardized baseline 18F-FDG-PET/CT prior to any given anti-myeloma treatment. Patients that had received steroids or bisphosphonates were excluded. Two experienced specialists, a nuclear medicine specialist (ANL) and a radiologist (JTA) evaluated the PET/CT. The lesion with the highest FDG uptake was described by a semi quantitative software ROVER for the values of lesion volume, SUVmax, SUVpeak, SUVmean and SUVmeancorr (SUVmean corrected for partial volume effects). Finally SUVmax was standardized to liver according to the Deauville criteria. Quantitative values were tested for correlation to prognostic indices ISS and revised ISS (R-ISS) using Kruskall Wallis test and Fischers exact test. STATA14 was used for analyses.3) ClinicalTrials.cov. ID: NCT02187731
Results
One patient had incomplete ISS data. Thus 34 patients were included in the analysis. 19, 11 and 4 patients were stratified into ISS group I, II and III, respectively. 9, 24 and 1 patient were stratified into the revised ISS group R-ISS1, R-ISS2 and R-ISS3, respectively. SUVmax values were between 3.6Mbq/ml and 27.8Mbq/ml and lesion volumes between 0.9ml and 216ml. 6 patients had Deauville score 3, and 12 Deauville score 4, and 6 patients had Deauville score 5. FDG uptake (SUVmax) standardized to liver showed correlation to ISS (p=0.03) but not the R-ISS (p=0.85). Absolute SUVmax, SUVpeak, SUVmean, SUVmeancorr were not correlated to neither ISS nor R-ISS (p values (0.3-0.8).
Conclusion
34 newly diagnosed MM patients were tested for association between FDG uptake values and the prognostic indices ISS and R-ISS. Only a marginal significant association between FDG uptake standardized to liver according to the Deauville criteria and ISS was observed. The use of FDG uptake values standardized to liver compensate for the general metabolic activity in the body and may therefore be more informative than absolute SUV values. Our cohort does not show a strong association between FDG SUV values and ISS or R-ISS, which may indicate that FDG PET offers prognostic information independent of R-ISS. At the meeting we will present an extended cohort. The association between FDG uptake values and prognostic factors in MM warrants further studies.
Session topic: E-poster
Keyword(s): FDG-PET, International prognostic index, Multiple myeloma
Type: Publication Only
Background
FDG-PET/CT is a promising methodology for staging, prognostication and response evaluation in multiple myeloma (MM). High intensity of FDG uptake measured as SUV (standard uptake value) at diagnosis is associated to more aggressive disease and reduced overall survival1,2 However, it is unknown if the informative value is independent of other prognostic markers.1) Bartel, T. B., et al. Blood 114.10 (2009): 2068-76.2) Zamagni, E., et al. Blood 118.23 (2011): 5989-95.
Aims
We aimed to investigate the association of the intensity of FDG uptake in the most intense focal lesions and established prognostic markers in MM, including ISS and revised ISS (R-ISS).
Methods
As a part of a prospective study3 with evaluation of new imaging technologies in MM we explored the first 35 included patients with treatment demanding MM. Patients were enrolled at diagnosis and studied with standardized baseline 18F-FDG-PET/CT prior to any given anti-myeloma treatment. Patients that had received steroids or bisphosphonates were excluded. Two experienced specialists, a nuclear medicine specialist (ANL) and a radiologist (JTA) evaluated the PET/CT. The lesion with the highest FDG uptake was described by a semi quantitative software ROVER for the values of lesion volume, SUVmax, SUVpeak, SUVmean and SUVmeancorr (SUVmean corrected for partial volume effects). Finally SUVmax was standardized to liver according to the Deauville criteria. Quantitative values were tested for correlation to prognostic indices ISS and revised ISS (R-ISS) using Kruskall Wallis test and Fischers exact test. STATA14 was used for analyses.3) ClinicalTrials.cov. ID: NCT02187731
Results
One patient had incomplete ISS data. Thus 34 patients were included in the analysis. 19, 11 and 4 patients were stratified into ISS group I, II and III, respectively. 9, 24 and 1 patient were stratified into the revised ISS group R-ISS1, R-ISS2 and R-ISS3, respectively. SUVmax values were between 3.6Mbq/ml and 27.8Mbq/ml and lesion volumes between 0.9ml and 216ml. 6 patients had Deauville score 3, and 12 Deauville score 4, and 6 patients had Deauville score 5. FDG uptake (SUVmax) standardized to liver showed correlation to ISS (p=0.03) but not the R-ISS (p=0.85). Absolute SUVmax, SUVpeak, SUVmean, SUVmeancorr were not correlated to neither ISS nor R-ISS (p values (0.3-0.8).
Conclusion
34 newly diagnosed MM patients were tested for association between FDG uptake values and the prognostic indices ISS and R-ISS. Only a marginal significant association between FDG uptake standardized to liver according to the Deauville criteria and ISS was observed. The use of FDG uptake values standardized to liver compensate for the general metabolic activity in the body and may therefore be more informative than absolute SUV values. Our cohort does not show a strong association between FDG SUV values and ISS or R-ISS, which may indicate that FDG PET offers prognostic information independent of R-ISS. At the meeting we will present an extended cohort. The association between FDG uptake values and prognostic factors in MM warrants further studies.
Session topic: E-poster
Keyword(s): FDG-PET, International prognostic index, Multiple myeloma
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