Intensity of bone involvement: a quantitative 18F-FDG PET/CT evaluation for monitoring outcome of multiple myeloma. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Takahashi, Maria Emilia Seren; Mosci, Camila; Duarte, Gislaine O.; Pericole, Fernando V.; Metze, Konradin; Lorand-Metze, Irene G.H.; Ramos, Celso D.
• Is Part Of: Nuclear medicine communications. Volume 42:Issue 12(2021)
• Publication Date: 2021-12
• Subjects: 18F-FDG -- intensity of bone involvement -- multiple myeloma -- PET-CT; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000001470
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Purpose: The parameter intensity of bone involvement (IBI) was recently proposed to quantitatively assess patients with multiple myeloma using 18 F-fluorodeoxyglucose-PET combined with computed tomography ( 18 F-FDG PET/CT) images. Here, we aimed to calculate IBI variation (ΔIBI) between two consecutive PET/CT of the same patient and verified its relationship with a subjective visual analysis of the images and with clinical outcome. Methods: Consecutive whole-body 18 F-FDG PET/CT performed to assess the outcomes of 29 patients diagnosed with multiple myeloma were retrospectively evaluated. ΔIBI was calculated after bone segmentation, using liver standardized uptake value as a threshold to determine metabolically active volumes in the skeleton. For each pair of consecutive PET/CTs, two nuclear medicine physicians classified visually the most recent image as PET-remission, PET-progression or PET-stable when compared to the previous examination. Results: The lowest ΔIBI was –1.27 and the highest was 0.29. PET-remission was related to ΔIBI <0 (median = –0.10; –1.27 to +0.03), while PET-progression was related to ΔIBI >0 (median = 0.02; –0.07 to +0.29). ΔIBI around zero was found in images classified as PET-stable (median = 0.00; –0.08 to +0.06). Significant difference in ΔIBI was found between the three groups. Multivariate stepwise analysis showed that IBI value at diagnostic PET/CT, serum calcium and percentage of plasma cells in the bone marrow are independent prognostic factors. Conclusion: Delta IBI provides quantitative data for variations of 18 F-FDG uptake in the bone marrow during the follow-up of the patients. In addition, higher IBI values at diagnosis are associated with a higher risk of patient's death.