Abstract
Purpose
We assessed the role of the maximum standardized uptake value (SUVmax) of bone marrow and the extramedullary lesion with the highest SUVmax in positron emission tomography/computed tomography (PET/CT) of newly diagnosed multiple myeloma (MM) patients in predicting overall survival (OS).
Methods
A total of 61 newly diagnosed patients (55 MM and 6 plasmacytoma) were enrolled in the study [37 men and 24 women with a median age of 57 years (range 28–80 years)]. The SUVmax of bone marrow and the extramedullary lesion in PET/CT was correlated with the levels of β2-microglobulin, C-reactive protein (CRP), albumin, creatinine, per cent of bone marrow plasma cells, serum free light chain (FLC) ratio, International Staging System (ISS) score and Durie-Salmon stage.
Results
The extramedullary lesion with the highest SUVmax showed significant correlation with bone marrow fluorodeoxyglucose (FDG) uptake (p = 0.027) and near significant correlation with ISS (p = 0.048). Bone marrow SUVmax correlated significantly with the per cent of bone marrow plasma cell count (p = 0.024), CRP (p = 0.012) and ISS (p = 0.013). In stage III MM the mean values of SUVmax in extramedullary lesions were significantly higher than stages I and II (6.23 ± 6.32 vs 2.85 ± 3.44, p = 0.023). The serum FLC ratio did not show any correlation with SUVmax of lesions and bone marrow (p > 0.05). Forty-four MM patients with FDG-positive lesions in PET/CT showed inferior 5-year estimated survival (61.73%) when compared to 11 patients without FDG-positive lesions, all of whom were alive (p = 0.01). In multivariate analysis an extramedullary lesion with the highest SUVmax was the only independent predictor of OS (p = 0.03).
Conclusion
PET/CT allows identification of high-risk myeloma patients, and extramedullary lesions with the highest SUVmax independently predict inferior OS.
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Haznedar, R., Akı, S.Z., Akdemir, Ö.U. et al. Value of 18F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma. Eur J Nucl Med Mol Imaging 38, 1046–1053 (2011). https://doi.org/10.1007/s00259-011-1738-8
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DOI: https://doi.org/10.1007/s00259-011-1738-8