title: 11C-acetate PET/CT for metabolic characterization of multiple myeloma: a comparative study with 18F-FDG PET/CT.
abstract: We prospectively compared (11)C-acetate with (18)F-FDG in a PET/CT evaluation of multiple myeloma (MM), specifically on diagnostic accuracy, identification of high-risk patients, and monitoring of treatment response.
  
  
  METHODS
  Dual-tracer PET/CT was performed on 35 pathologically and clinically confirmed and untreated patients (26 with symptomatic MM, 5 with smoldering MM, and 4 with monoclonal gammopathy of unknown significance) and 20 individuals with normal marrow.
  
  
  RESULTS
  (11)C-acetate showed significant incremental value over (18)F-FDG (84.6% vs. 57.7%) for positively identifying patients with diffuse and focal symptomatic MM, and was negative in patients with indolent smoldering MM and monoclonal gammopathy of unknown significance. Three functional parameters-number of (11)C-acetate-avid and (18)F-FDG-avid focal bone lesions and (11)C-acetate general marrow activity-strongly correlated with β-2-microglobulin as surrogate imaging markers of tumor burden. After induction chemotherapy, the metabolic change in (11)C-acetate general marrow activity correlated with clinical response.
  
  
  CONCLUSIONS
  Metabolic characterization of MM in diagnosis, risk stratification, and treatment monitoring can be done more accurately by assessing lipid metabolism with (11)C-acetate than by assessing glucose metabolism with (18)F-FDG.
authors.affiliation: Department of Nuclear Medicine and PET, Hong Kong Sanatorium and Hospital, Hong Kong.
authors.forename: Chi-lai
authors.initials: CL
authors.lastname: Ho
authors.forename: Sirong
authors.initials: S
authors.lastname: Chen
authors.forename: Yim Lung
authors.initials: YL
authors.lastname: Leung
authors.forename: Thomas
authors.initials: T
authors.lastname: Cheng
authors.forename: Ka-nin
authors.initials: KN
authors.lastname: Wong
authors.forename: Shing Kee
authors.initials: SK
authors.lastname: Cheung
authors.forename: Raymond
authors.initials: R
authors.lastname: Liang
authors.forename: Chor Sang
authors.initials: CS
authors.lastname: Chim
mesh_terms: D000085:Acetates; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009101:Multiple Myeloma / Q000000981:diagnostic imaging*; D010265:Paraproteinemias / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012306:Risk; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D000085:Acetates; D019275:Radiopharmaceuticals; C438206:carbon-11 acetate; D019788:Fluorodeoxyglucose F18; D002244:Carbon; D005947:Glucose
keywords: 11C-acetate; beta-2-microglobulin; myeloma