title: The value of FDG PET/CT in the initial staging and bone marrow involvement of patients with multiple myeloma.
abstract: OBJECTIVE
  The aim of this study was to describe the role of positron emission tomography/computed tomography (PET/CT) with fluorine-18 fluorodeoxyglucose (FDG) in the detection of skeletal and visceral involvement in patients with MM (multiple myeloma) at the initial diagnosis and to evaluate the relation between maximum standardized uptake values (SUVmax) of FDG with bone marrow cellularity and plasma cell ratios.
  
  
  METHODS
  The study population consisted of 42 patients (15 F, 28 M; mean ± SD age; 47 ± 12 years). Thirty-two patients were referred for initial diagnosis and ten patients were referred for assessment of therapy response. PET/CT scan was obtained 60 min after the administration of 5.4 MBq/kg FDG. The SUVmax of FDG uptake was measured from the region of interest, which was placed at the site of most prominent lesion in bone marrow in PET/CT images.
  
  
  RESULTS
  Thirty patients were positive (29 of 32 initially diagnosed, one of ten previously treated) and 12 patients were negative on PET/CT scan. Conventional radiological methods were negative in three of 30 FDG PET/CT-positive patients and these methods did not show any pathological finding in 12 FDG PET/CT-negative patients. The sensitivity of FDG PET in detecting bone marrow involvement at initial diagnosis was 90%. There was a significant correlation between SUVmax values and bone marrow biopsy cellularity and plasma cell ratios, (r = 0.54 and r = 0.74, p < 0.01).
  
  
  CONCLUSIONS
  The results of this study demonstrated that FDG-PET is a useful technique for the assessment of MM and the correlation between SUVmax and plasma cell ratios in bone marrow biopsy may avoid repeated bone marrow biopsies in the follow-up period.
authors.affiliation: Clinic of Nuclear Medicine, Istanbul Education and Research Hospital, Org. Abdurrahman Nafiz Gürman Cad, Samatya, Fatih, Istanbul, Turkey. saitsager@yahoo.com
authors.forename: Sait
authors.initials: S
authors.lastname: Sager
authors.forename: Nurhan
authors.initials: N
authors.lastname: Ergül
authors.forename: Hediye
authors.initials: H
authors.lastname: Ciftci
authors.forename: Güven
authors.initials: G
authors.lastname: Cetin
authors.forename: Sebnem Izmir
authors.initials: SI
authors.lastname: Güner
authors.forename: Teyfik Fikret
authors.initials: TF
authors.lastname: Cermik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18