11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma.
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.
Nanni
Cristina
C
Nuclear Medicine, PET Unit, Policlinico S. Orsola-Malpighi, Bologna University, Italy. rubello.domenico@azisanrovigo.it
Zamagni
Elena
E
Cavo
Michele
M
Rubello
Domenico
D
Tacchetti
Paola
P
Pettinato
Cinzia
C
Farsad
Mohsen
M
Castellucci
Paolo
P
Ambrosini
Valentina
V
Montini
Gian Carlo
GC
Al-Nahhas
Adil
A
Franchi
Roberto
R
Fanti
Stefano
S
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
D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002794:Choline