Value of FDG PET in the assessment of patients with multiple myeloma
Value of FDG PET in the assessment of patients with multiple myeloma
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DOI：
10.2214/ajr.184.4.01841199
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发表时间：
2005-04-01
影响因子：
5
通讯作者：
Hawkins, R
中科院分区：
文献类型：
--
作者：
Bredella, MA;Steinbach, L;Hawkins, R
objective.我们的目的是评估全身PET与FDG是否能够检测多发性骨髓瘤患者的骨髓受累，并评估其外观和分布模式。对13例多发性骨髓瘤患者进行了17次全身FDG PET扫描。4例患者接受治疗前疾病程度评价，9例患者接受治疗反应（化疗、放疗、骨髓移植）评估。评价FDG PET图像的分布和摄取模式。获得标准化摄取值以量化FDG摄取。其他影像学检查（MRI、CT、X线摄影）、实验室数据、活检和临床过程的结果用于验证检测到的病变。FDG PET能够检测多发性骨髓瘤的骨髓受累。有两个假阴性结果。在1例患者中，放射学骨骼调查显示肋骨内的FDG PET未检测到的亚厘米溶解性病变，在另1例患者中，放射学检查发现的溶解性病变仅显示FDG摄取轻度增加，未前瞻性确定。在PET前3周接受放射治疗的患者中有1例FDG PET假阳性结果。FDGPET有助于鉴别治疗后改变和残留/复发肿瘤以及评估治疗反应。FDG PET导致4例患者的疾病分期升高，这影响了随后的治疗和预后。FDGPET检测骨髓瘤侵犯的敏感性为85%，特异性为92%。FDG PET能够检测多发性骨髓瘤患者的骨髓受累。FDG PET在初步诊断时可用于评估疾病的程度，有助于更准确地分期。FDG PET也可用于评估治疗反应。
OBJECTIVE. Our objective was to evaluate if whole-body PET with FDG is able to detect bone marrow involvement in patients with multiple myeloma and to assess its appearance and distribution pattern.MATERIALS AND METHODS. Seventeen whole-body FDG PET scans were performed in 13 patients with multiple myeloma. Four patients were referred for evaluation of extent of disease pretherapy and nine patients were referred for assessment of therapy response (chemotherapy, radiation therapy, bone marrow transplant). FDG PET images were evaluated for distribution and uptake pattern. Standardized uptake values were obtained to quantify FDG uptake. Results of other imaging examinations (MRI, CT, radiography), laboratory data, biopsies, and the clinical course were used for verification of detected lesions.RESULTS. FDG PET was able to detect medullary involvement of multiple myeloma. There were two false-negative results. In one patient, the radiographic skeletal survey showed subcentimeter lytic lesions within the ribs that were not detected on FDG PET and in the other patient, a lytic lesion detected on radiographs showed only mildly increased FDG uptake that was not identified prospectively. There was one false-positive FDG PET result in a patient who had undergone radiation therapy 3 weeks before PET. FDG PET was helpful in differentiating between posttherapeutic changes and residual/recuffent tumor and in assessing response to therapy. FDG PET resulted in upstaging of disease in four patients, which influenced subsequent management and prognosis. Sensitivity of FDG PET in detecting myelomatous involvement was 85% and specificity was 92%.CONCLUSION. FDG PET is able to detect bone marrow involvement inpatients with multiple myeloma. FDG PET is useful in assessing extent of disease at time of initial diagnosis, contributing to staging that is more accurate. FDG PET is also useful for evaluating therapy response.