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18F-FDG PET/CT is useful for determining survival outcomes of patients with multiple myeloma classified as stage II and III with the Revised International Staging System

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Abstract

Purpose

This study evaluated the prognostic role of 18F-FDG PET/CT at baseline in patients with newly diagnosed multiple myeloa (MM) and evaluated the prognostic relevance of 18F-FDG PET/CT for each stage according to the Revised International Staging System (R-ISS).

Method

We retrospectively analyzed the records of 167 patients with newly diagnosed MM. 18F-FDG PET/CT was performed prior to induction therapy in patients with newly diagnosed MM.

Results

In the total cohort, the presence of more than three hypermetabolic focal lesions (FLs) or extramedullary disease (EMD) on baseline PET/CT was associated with significantly inferior progression-free survival (PFS) and overall survival (OS) than other patients. Because most patients (91%) with EMD had more than three FLs, PET/CT positivity was defined as the presence of more than three FLs or the presence of EMD. In multivariate analyses, PET/CT positivity was an independent predictor of PFS and OS in all patients. Fifty-five patients (46.1%) with R-ISS II were PET/CT-positive at baseline and had significantly shorter PFS and OS. PET/CT positivity was also correlated with poor PFS and OS in patients with R-ISS III.

Conclusion

18F-FDG PET/CT was an independent predictor of survival outcomes in patients with newly diagnosed MM. In addition, performing 18F- FDG PET/CT at diagnosis may be useful for determining the survival outcomes of MM patients with R-ISS II and III.

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Authors and Affiliations

  1. Department of Hematology–Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo, 519-763, Republic of Korea

    Sung-Hoon Jung, Seo-Yeon Ahn, Seung-Yeon Jung, Deok-Hwan Yang, Jae-Sook Ahn, Hyeoung-Joon Kim & Je-Jung Lee

  2. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea

    Seong Young Kwon, Jung-Joon Min & Hee-Seung Bom

  3. Department of Hematology-Oncology, Wonkwang University Hospital, Iksan, Republic of Korea

    Seung-Shin Lee & Moo-Rim Park

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  1. Sung-Hoon Jung
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Contributions

S.H.J. and J.J.L. designed the study and S.H.J. prepared the manuscript; S.Y.K., J.J.M., and H.S.M. performed the image analysis; S.Y.A., S.Y.J., S.S.L., M.R.P., D.H.Y., J.S.A., and H.J.K. critically reviewed the manuscript. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Je-Jung Lee.

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The authors have no conflicts of interest.

Ethical approval

All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Jung, SH., Kwon, S.Y., Min, JJ. et al. 18F-FDG PET/CT is useful for determining survival outcomes of patients with multiple myeloma classified as stage II and III with the Revised International Staging System. Eur J Nucl Med Mol Imaging 46, 107–115 (2019). https://doi.org/10.1007/s00259-018-4114-0

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