title: The value of 18F-FDG PET/CT after autologous stem cell transplantation (ASCT) in patients affected by multiple myeloma (MM): experience with 77 patients.
abstract: OBJECTIVE
  The objective of this study was to analyze the prognostic value of (18)F-FDG PET/CT after therapy in patients with multiple myeloma (MM).
  
  
  METHODS
  One hundred seven patients prospectively recruited with MM had FDG PET/CT at staging 3 months after therapy (autologous stem cell transplantation) and every 6 to 12 months during the follow-up (mean 41 months). Patients were divided into group 1 (relapsed) and group 2 (nonrelapsed). In group 1, PET results and SUV(max) were compared to the time to relapse (TTR). In group 2, the presence of PET finding changes during follow-up was analyzed to identify typical patterns of disease behavior (ie, late responders or stabilized disease). Patients with a negative PET at staging were excluded from further evaluation.
  
  
  RESULTS
  Forty-seven out of 107 (44%) patients relapsed: 10 were excluded because of a negative PET at staging. In group 1, 22 patients had a negative posttherapy PET (59%, mean TTR = 27.6 months) and 15 had a positive posttherapy PET (41%, mean TTR = 18 months). There was a significant difference between the TTR of the two subgroups (t test P = 0.05). In patients with a positive posttherapy PET, the SUV(max) was inversely correlated to the TTR (correlation coefficient = -0.7; P < 0.01).Sixty out of 107 (56%) patients did not relapse. Twenty patients were excluded because of a negative PET at staging. In group 2, 27 patients had a negative posttherapy PET (68%) and 13 had a positive posttherapy PET (32%). None of nonrelapsed patients showed a progressive increase in SUV(max) during the follow-up. There was no significant difference between relapsed and nonrelapsed patients in terms of SUV(max) at posttherapy PET/CT (t test P = 0.7).
  
  
  CONCLUSIONS
  In our series of MM patients, a negative posttherapy PET was predictive for nonrelapse or a long disease-free survival. In contrast, a persistent significantly increased SUV(max) after therapy was correlated to a short TTR.
authors.affiliation: Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Nanni
authors.forename: Elena
authors.initials: E
authors.lastname: Zamagni
authors.forename: Monica
authors.initials: M
authors.lastname: Celli
authors.forename: Paola
authors.initials: P
authors.lastname: Caroli
authors.forename: Valentina
authors.initials: V
authors.lastname: Ambrosini
authors.forename: Paola
authors.initials: P
authors.lastname: Tacchetti
authors.forename: Annamaria
authors.initials: A
authors.lastname: Brioli
authors.forename: Beatrice
authors.initials: B
authors.lastname: Zannetti
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pezzi
authors.forename: Lucia
authors.initials: L
authors.lastname: Pantani
authors.forename: Giulia
authors.initials: G
authors.lastname: Perrone
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Colletti
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
mesh_terms: D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000601:surgery*; D049268:Positron-Emission Tomography; D011379:Prognosis; D033581:Stem Cell Transplantation; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous
chemical_list: D019788:Fluorodeoxyglucose F18