title: 18 FDG-PET/CT for prognostic stratification of patients with multiple myeloma relapse after stem cell transplantation.
abstract: The aim of this study was to investigate the prognostic value of 18F-fluoro-deoxyglucose positron emission tomography-computed tomography (18F-FDG-PET/CT) in 37 patients with a history of multiple myeloma (MM) and suspected or confirmed recurrence after stem cell transplantation (SCT). All patients had been heavily pre-treated. Time to progression (TTP) and overall survival (OS) were correlated to a number of different PET-derived as well as clinical parameters. Impact on patient management was assessed. Absence of FDG-avid MM foci was a positive prognostic factor for both TTP and OS (p<0.01). Presence of >10 focal lesions correlated with both TTP (p<0.01) and OS (p<0.05). Interestingly, presence of >10 lesions in the appendicular skeleton proved to have the strongest association with disease progression. Intensity of glucose uptake and presence of extramedullary disease were associated with shorter TTP (p=0.037 and p=0.049, respectively). Manifestations in soft tissue structures turned out to be a strong negative predictor for both, TTP and OS (p<0.01, respectively). PET resulted in a change of management in 30% of patients. Our data underline the prognostic value of 18F-FDG-PET/CT in MM patients also in the setting of post-SCT relapse. PET/CT has a significant impact on patient management.
authors.affiliation: Department of Nuclear Medicine,Medical Center, University of Würzburg, Würzburg. Contributed equally to this work.
authors.forename: Constantin
authors.initials: C
authors.lastname: Lapa
authors.affiliation: Department of Nuclear Medicine,Medical Center, University of Würzburg, Würzburg. Contributed equally to this work.
authors.forename: Katharina
authors.initials: K
authors.lastname: Lückerath
authors.affiliation: Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg. Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg.
authors.forename: Uwe
authors.initials: U
authors.lastname: Malzahn
authors.affiliation: Department of Nuclear Medicine,Medical Center, University of Würzburg, Würzburg.
authors.forename: Samuel
authors.initials: S
authors.lastname: Samnick
authors.affiliation: Department of Hematology and Oncology,Medical Center, University of Würzburg, Würzburg.
authors.forename: Herrmann
authors.initials: H
authors.lastname: Einsele
authors.affiliation: Department of Nuclear Medicine,Medical Center, University of Würzburg, Würzburg.
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Buck
authors.affiliation: Department of Nuclear Medicine,Medical Center, University of Würzburg, Würzburg.
authors.forename: Ken
authors.initials: K
authors.lastname: Herrmann
authors.affiliation: Department of Hematology and Oncology,Medical Center, University of Würzburg, Würzburg.
authors.forename: Stefan
authors.initials: S
authors.lastname: Knop
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012008:Recurrence; D033581:Stem Cell Transplantation; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18