title: 18F-FDG PET/CT for detection and localization of residual or recurrent disease in patients with multiple myeloma after stem cell transplantation.
abstract: OBJECTIVE
  The aim of the study was to determine the diagnostic performance of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for the detection and localization of residual or recurrent disease in patients with multiple myeloma (MM) after stem cell transplantation.
  
  
  METHODS
  A total of 197 whole-body (18)F-FDG PET/CT scans were performed in 99 patients with MM at different time points in the course of disease after autologous or allogeneic stem cell transplantation. Post-transplant PET/CT scans and clinical remission status as determined by the clinical gold standard (Uniform Response Criteria) were analysed and compared.
  
  
  RESULTS
  A total of 576 focal osseous and extramedullary lesions were detected in 79 scans. Additional diffuse bone marrow involvement was detected in 17 patients. (18)F-FDG PET/CT had a sensitivity of 54.6%, a specificity of 82.1%, a positive predictive value of 82.3%, a negative predictive value of 54.2% and an overall accuracy of 65.5%. The sensitivity of (18)F-FDG PET/CT was shown to depend on the disease category according to the Uniform Response Criteria for myeloma.
  
  
  CONCLUSIONS
  In patients with MM in the post-transplant setting, (18)F-FDG PET/CT may (1) contribute to the detection and localization of disease, (2) provide information about the extent of distinct myeloma manifestations and the total disease burden and (3) add information about the metabolic activity of disease, but (4) has substantially lower sensitivity for this purpose compared to the pretreatment setting.
authors: Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. t.derlin@uke.uni-hamburg.de
authors: Thorsten
authors: T
authors: Derlin
authors: Christoph
authors: C
authors: Weber
authors: Christian R
authors: CR
authors: Habermann
authors: Jochen
authors: J
authors: Herrmann
authors: Christian
authors: C
authors: Wisotzki
authors: Francis
authors: F
authors: Ayuk
authors: Christine
authors: C
authors: Wolschke
authors: Susanne
authors: S
authors: Klutmann
authors: Nicolaus
authors: N
authors: Kröger
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography; D012008:Recurrence; D012015:Reference Standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D019788:Fluorodeoxyglucose F18