Skip to main content

Advertisement

SpringerLink
Log in

Comparative diagnostic performance of 18F-FDG PET/CT versus whole-body MRI for determination of remission status in multiple myeloma after stem cell transplantation

  • Nuclear Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare the diagnostic performance of whole-body magnetic resonance imaging (WBMRI) versus 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for determination of remission status in patients with multiple myeloma (MM) after stem cell transplantation (SCT).

Methods

Thirty-one patients were examined by both WBMRI and PET/CT after SCT. Imaging results and clinical remission status as determined by the clinical gold standard (Uniform Response Criteria) were compared.

Results

One hundred four lesions were detected in 21 patients. PET/CT had a sensitivity of 50.0 %, a specificity of 85.7 %, a positive predictive value of 62.5 %, a negative predictive value of 78.3 %, and an overall accuracy of 74.2 % for determination of remission status. MRI had a sensitivity of 80.0 %, a specificity of 38.1 %, a positive predictive value of 38.1 %, a negative predictive value of 80 %, and an overall accuracy of 51.6 %. Concordant results were observed in only 12 (11.5 %) of the 104 lesions.

Conclusions

In the post-treatment setting, both FDG PET/CT and WBMRI provide information about the extent of disease, allowing for a more comprehensive evaluation of persisting or recurrent myeloma. MRI may often be false positive because of persistent non-viable lesions. Therefore, PET/CT might be more suitable than MRI for determination of remission status.

Key Points

• Both whole-body MRI and 18 F-FDG PET/CT are now used for assessing multiple myeloma

• Both investigations may visualise residual or recurrent disease after stem cell transplantation

• MRI may give false-positive results because of persistent inactive lesions

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bataille R, Harousseau JL (1997) Multiple myeloma. N Engl J Med 336:1657–1664

    Article  PubMed  CAS  Google Scholar 

  2. Sirohi B, Powles R (2004) Multiple myeloma. Lancet 363:875–887

    Article  PubMed  Google Scholar 

  3. Kroger N (2007) Mini-midi-maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation. Leukemia 21:1851–1858

    Article  PubMed  CAS  Google Scholar 

  4. Zamagni E, Patriarca F, Nanni C et al (2011) Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation. Blood 118:5989–5995

    Article  PubMed  CAS  Google Scholar 

  5. Durie BG, Harousseau JL, Miguel JS et al (2006) International uniform response criteria for multiple myeloma. Leukemia 20:1467–1473

    Article  PubMed  CAS  Google Scholar 

  6. Derlin T, Weber C, Habermann CR et al (2012) 18F-FDG PET/CT for detection and localization of residual or recurrent disease in patients with multiple myeloma after stem cell transplantation. Eur J Nucl Med Mol Imaging 39:493–500

    Article  PubMed  Google Scholar 

  7. Lin C, Luciani A, Belhadj K et al (2010) Multiple myeloma treatment response assessment with whole-body dynamic contrast-enhanced MR imaging. Radiology 254:521–531

    Article  PubMed  Google Scholar 

  8. Blade J, Samson D, Reece D et al (1998) Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol 102:1115–1123

    Article  PubMed  CAS  Google Scholar 

  9. Durie BG, Waxman AD, D’Agnolo A, Williams CM (2002) Whole-body (18)F-FDG PET identifies high-risk myeloma. J Nucl Med 43:1457–1463

    PubMed  Google Scholar 

  10. Bartel TB, Haessler J, Brown TL et al (2009) F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood 11:2068–2076

    Article  Google Scholar 

  11. Nanni C, Zamagni E, Farsad M et al (2006) Role of 18F-FDG PET/CT in the assessment of bone involvement in newly diagnosed multiple myeloma: preliminary results. Eur J Nucl Med Mol Imaging 33:525–531

    Article  PubMed  Google Scholar 

  12. Durie BG (2006) The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer 42:1539–1543

    Article  PubMed  Google Scholar 

  13. Becherer A, De Santis M, Karanikas G et al (2005) FDG PET is superior to CT in the prediction of viable tumour in post-chemotherapy seminoma residuals. Eur J Radiol 54:284–288

    Article  PubMed  Google Scholar 

  14. Kobe C, Dietlein M, Franklin J et al (2008) Positron emission tomography has a high negative predictive value for progression or early relapse for patients with residual disease after first-line chemotherapy in advanced-stage Hodgkin lymphoma. Blood 112:3989–3994

    Article  PubMed  CAS  Google Scholar 

  15. Baur-Melnyk A, Buhmann S, Durr HR, Reiser M (2005) Role of MRI for the diagnosis and prognosis of multiple myeloma. Eur J Radiol 55:56–63

    Article  PubMed  Google Scholar 

  16. Fonti R, Salvatore B, Quarantelli M et al (2008) 18F-FDG PET/CT, 99mTc-MIBI, and MRI in evaluation of patients with multiple myeloma. J Nucl Med 49:195–200

    Article  PubMed  Google Scholar 

  17. Zamagni E, Nanni C, Patriarca F et al (2007) A prospective comparison of 18F-fluorodeoxyglucose positron emission tomography-computed tomography, magnetic resonance imaging and whole-body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma. Haematologica 92:50–55

    Article  PubMed  Google Scholar 

  18. Bauerle T, Hillengass J, Fechtner K et al (2009) Multiple myeloma and monoclonal gammopathy of undetermined significance: importance of whole-body versus spinal MR imaging. Radiology 252:477–485

    Article  PubMed  Google Scholar 

  19. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  PubMed  CAS  Google Scholar 

  20. Dimopoulos M, Terpos E, Comenzo RL et al (2009) International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple myeloma. Leukemia 23:1545–1556

    Article  PubMed  CAS  Google Scholar 

  21. Kwee TC, Basu S, Saboury B, Ambrosini V, Torigian DA, Alavi A (2011) A new dimension of FDG-PET interpretation: assessment of tumor biology. Eur J Nucl Med Mol Imaging 38:1158–1170

    Article  PubMed  Google Scholar 

  22. Shortt CP, Gleeson TG, Breen KA et al (2009) Whole-Body MRI versus PET in assessment of multiple myeloma disease activity. AJR Am J Roentgenol 192:980–986

    Article  PubMed  Google Scholar 

  23. Paiva B, Vidriales MB, Cervero J et al (2008) Multiparameter flow cytometric remission is the most relevant prognostic factor for multiple myeloma patients who undergo autologous stem cell transplantation. Blood 112:4017–4023

    Article  PubMed  CAS  Google Scholar 

  24. Horger M, Weisel K, Horger W, Mroue A, Fenchel M, Lichy M (2011) Whole-body diffusion-weighted MRI with apparent diffusion coefficient mapping for early response monitoring in multiple myeloma: preliminary results. AJR Am J Roentgenol 196:W790–W795

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Thorsten Derlin, Kersten Peldschus, Peter Bannas, Jochen Herrmann, Christian R. Habermann, Gerhard Adam & Christoph Weber

  2. Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Silvia Münster

  3. Clinic for Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Thomas Stübig & Nicolaus Kröger

Authors
  1. Thorsten Derlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kersten Peldschus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Silvia Münster
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter Bannas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jochen Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas Stübig
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christian R. Habermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gerhard Adam
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nicolaus Kröger
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Christoph Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thorsten Derlin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Derlin, T., Peldschus, K., Münster, S. et al. Comparative diagnostic performance of 18F-FDG PET/CT versus whole-body MRI for determination of remission status in multiple myeloma after stem cell transplantation. Eur Radiol 23, 570–578 (2013). https://doi.org/10.1007/s00330-012-2600-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-012-2600-5

Keywords

Search

Navigation