title: 11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma.
abstract: BACKGROUND
  Multiple Myeloma (MM) is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS), Magnetic resonance (MR) and 18F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients.
  
  
  OBJECTIVE
  As MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM.
  
  
  METHODS
  Ten patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results of the two scans were compared in terms of number, sites and SUVmax of lesions.
  
  
  RESULTS
  Four patients (40%) had a negative concordant 11C-Choline and 18F-FDG PET/CT scans. Two patients (20%) had a positive 11C-Choline and 18F-FDG PET/CT scans that identified the same number and sites of bone lesions. The remaining four patients (40%) had a positive 11C-Choline and 18F-FDG PET/CT scan, but the two exams identified different number of lesions. Choline showed a mean SUVmax of 5 while FDG showed a mean SUVmax of 3.8 (P = 0.042). Overall, 11C-Choline PET/CT scans detected 37 bone lesions and 18F-FDG PET/CT scans detected 22 bone lesions but the difference was not significant (P = 0.8).
  
  
  CONCLUSIONS
  According to these preliminary data, 11C-Choline PET/CT appears to be more sensitive than 18F-FDG PET/CT for the detection of bony myelomatous lesions. If these data are confirmed in larger series of patients, 11C-Choline may be considered a more appropriate functional imaging in association with MRI for MM bone staging.
authors.affiliation: Nuclear Medicine, PET Unit, Policlinico S. Orsola-Malpighi, Bologna University, Italy. rubello.domenico@azisanrovigo.it
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Elena
authors.initials: E
authors.lastname: Zamagni
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Paola
authors.initials: P
authors.lastname: Tacchetti
authors.forename: Cinzia
authors.initials: C
authors.lastname: Pettinato
authors.forename: Mohsen
authors.initials: M
authors.lastname: Farsad
authors.forename: Paolo
authors.initials: P
authors.lastname: Castellucci
authors.forename: Valentina
authors.initials: V
authors.lastname: Ambrosini
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Montini
authors.forename: Adil
authors.initials: A
authors.lastname: Al-Nahhas
authors.forename: Roberto
authors.initials: R
authors.lastname: Franchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002250:Carbon Radioisotopes; D002794:Choline; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002794:Choline