• Anticancer research · Apr 2019

    Characterization of Bone Lesions in Myeloma Before and During Anticancer Therapy Using 18F-FDG-PET/CT and 18F-NaF-PET/CT.

    • Thomas Selim Nakuz, Filipe Portela Millinger, Karem El-Rabadi, Michael Weber, Verena Pichler, Wolfgang Wadsak, Markus Mitterhauser, Alexander Haug, Marcus Hacker, Georgios Karanikas, Peter Pietschmann, and Hermine Agis.
    • Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria.
    • Anticancer Res. 2019 Apr 1; 39 (4): 1943-1952.

    BackgroundThe objective of this study was to characterize tumor activity and mineralization status in newly-detected multiple myeloma (MM) bone lesions using 2-18F-fluoro-2-deoxy-D-glucose (18F-FDG)-PET/CT and 18F-sodium fluoride (18F-NaF)-PET/CT before and after antitumor treatment.Materials And MethodsIn this retrospective study, seven patients with histologically-verified MM were included (four women, three men; median age=57 years, standard deviation=11.23 years). PET/CT was performed with 18F-FDG and with 18F-NaF, both at baseline and after treatment. All patients had positive scans. Volumes of interest (VOIs) were drawn over all 18F-FDG-PET/CT-positive bone lesions, as well as the corresponding regions in 18F-NaF-PET/CT. For characterization of bone lesions, semi-quantitative standard uptake value (SUV) parameters were measured.Results18F-FDG-PET/CT in the seven patients detected 39 metabolically active lesions that were correlated with the corresponding sites in 18F-fluoride-PET/CT. Overall, the lesions showed a response to therapy, with a significant decrease in SUVmax on PET/CT using 18F-FDG (p<0.001) and with 18F-NaF (p<0.001). In four patients with a second follow-up scan (at a median of 17 months after baseline scan), there was no significant change in lesion uptake.ConclusionBased on our data, antitumor therapy in MM reduces not only tumor activity, but also the mineralization status of bone lesions. A second follow-up scan in a subset of the cohort yielded no change in mineralization status.Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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