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18F-FAMT in patients with multiple myeloma: clinical utility compared to 18F-FDG

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Abstract

Objective

l-[3-18F]-alpha-methyltyrosine (18F-FAMT) is an amino-acid tracer for positron emission tomography (PET), with uptake related to overexpression of L-type amino-acid transporter 1 and proliferative activity in tumour cells. This study evaluated the diagnostic performance of 18F-FAMT PET compared with 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) PET in patients with multiple myeloma (MM).

Methods

Eleven patients with MM (newly diagnosed, n = 3; relapsed after treatment, n = 8) underwent whole-body 18F-FAMT and 18F-FDG PET within a 2-week interval. Magnetic resonance imaging (MRI) of the spine was also performed to assess patterns of bone marrow infiltration. Tracer uptake was semi-quantitatively evaluated using maximal standardized uptake value (SUVmax). Mean SUV was also determined for normal bone marrow and the aortic arch as mediastinal background SUV to calculate lesion-to-bone marrow (L/B) and lesion-to-mediastinum (L/M) ratios, respectively. Those values were statistically compared using Student’s t test.

Results

In 8 patients showing focal infiltration on MRI, 34 FDG-avid bone lesions were identified, with each showing increased FAMT uptake. Mean SUVmax and L/B ratio of FDG (3.1 ± 1.2 and 3.3 ± 1.9, respectively) were significantly higher than those of FAMT (2.0 ± 1.0 and 2.6 ± 1.1, respectively; p < 0.05 each). In contrast, the L/M ratio of FDG showed no significant difference to that of FAMT (2.2 ± 1.0 and 2.4 ± 1.2, respectively; p = 0.3).

Conclusions

Clear 18F-FAMT PET uptake was seen in most 18F-FDG-avid lesions among patients with MM, and an equivalent semi-quantitative value was obtained using L/M ratio. Our preliminary data suggest that 18F-FAMT PET provides a useful imaging modality for detecting active myelomatous lesions.

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None of the authors have any conflicts of interest associated with this study.

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Correspondence to Atsushi Isoda.

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Isoda, A., Higuchi, T., Nakano, S. et al. 18F-FAMT in patients with multiple myeloma: clinical utility compared to 18F-FDG. Ann Nucl Med 26, 811–816 (2012). https://doi.org/10.1007/s12149-012-0645-9

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  • DOI: https://doi.org/10.1007/s12149-012-0645-9

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