Prognostic Impact of Metabolic Heterogeneity in Patients with Newly Diagnosed Multiple Myeloma Using 18F-FDG PET/CT

Toshiki Terao, Youichi MacHida, Kenji Hirata, Ayumi Kuzume, Rikako Tabata, Takafumi Tsushima, Daisuke Miura, Kentaro Narita, Masami Takeuchi, Ukihide Tateishi, Kosei Matsue

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Purpose This study aimed to investigate the prognostic impact of metabolic heterogeneity (MH) in patients with multiple myeloma (MM). Patients and Methods We retrospectively analyzed MH with 18F-FDG PET/CT in 203 patients with newly diagnosed MM. Metabolic heterogeneity was estimated using the area under the curve of the cumulative SUV volume histogram. To evaluate MH, we selected 2 lesions: "MH-SUVmax,"a lesion with SUVmax, and "MH-metabolic tumor volume (MTV),"a lesion with the largest MTV. Results Metabolic heterogeneity from an MH-SUVmax lesion showed more prognostic relevance than that from a lesion with the largest MTV. The progression-free survival (PFS) and overall survival (OS) rates were significantly lower in the high-MH-SUVmax group than in the low-MH-SUVmax group (median PFS: 25.2 vs 33.9 months; median OS: 41.6 vs 112.0 months; P = 0.004 and 0.046, respectively), whereas high MH-SUVmax retained independent prognostic power on multivariate analysis. Even among patients with high whole-body MTV, those with high MH-SUVmax tended to show poorer prognosis than those without (median PFS, 23.8 vs 30.2 months; P = 0.085). Moreover, patients with high MH-SUVmax and high-risk cytogenetic abnormalities showed dismal outcomes even with standard treatment (median PFS and OS, 10.0 and 33.3 months, respectively). Conclusions Our results suggested that high MH-SUVmax based on pretreatment with 18F-FDG PET/CT is a novel prognostic factor for cases of MM.

Original languageEnglish
Pages (from-to)790-796
Number of pages7
JournalClinical Nuclear Medicine
Volume46
Issue number10
DOIs
Publication statusPublished - Oct 1 2021
Externally publishedYes

Keywords

  • F-FDG PET
  • metabolic heterogeneity
  • MTV
  • multiple myeloma
  • SUV

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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