Prognostic Value of Baseline ¹⁸F-Fluorodeoxyglucose PET/CT in Patients with Multiple Myeloma: A Multicenter Cohort Study.
10.3348/kjr.2018.19.3.481
- Author:
Seung Hwan MOON
1
;
Woo Hee CHOI
;
Ie Ryung YOO
;
Soo Jin LEE
;
Jin Chul PAENG
;
Shin Young JEONG
;
Sang Woo LEE
;
Kihyun KIM
;
Joon Young CHOI
Author Information
1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. jynm.choi@samsung.com
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Multiple myeloma;
¹⁸F-FDG;
PET/CT;
Prognosis
- MeSH:
Cohort Studies*;
Disease-Free Survival;
Electrons;
Fluorodeoxyglucose F18;
Humans;
Kaplan-Meier Estimate;
Multiple Myeloma*;
Multivariate Analysis;
Positron-Emission Tomography and Computed Tomography*;
Prognosis
- From:Korean Journal of Radiology
2018;19(3):481-488
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We investigated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with multiple myeloma (MM). MATERIALS AND METHODS: Subjects were 76 patients with newly diagnosed myeloma and pretreatment with 18F-FDG PET/CT from four hospitals. The PET/CT features were evaluated and the clinical characteristics were reviewed. Prognostic factors related to poor progression-free survival (PFS) and overall survival (OS) were identified using a Cox proportional hazards regression model and a prediction scale was developed based on the identified factors. RESULTS: Multivariate analysis showed that the presence of 18F-FDG-avid focal bone lesions (≥ 3) was a significant and independent predictor of PFS (hazard ratio [HR] = 3.28, p = 0.007) and OS (HR = 11.78, p = 0.001). The presence of extramedullary disease on PET/CT scan was also a significant predictor of poor PFS (HR = 2.79, p = 0.006) and OS (HR = 3.89, p = 0.003). A prognostic scale was developed using these two predictors. An increase in score on the scale corresponded to a significantly increased risk of poor OS (p = 0.005). In addition, Kaplan-Meier analysis demonstrated that patient survival varied significantly according to the scale (p < 0.001 for OS and p = 0.001 for PFS). CONCLUSION: 18F-FDG-avid focal lesions and the presence of extramedullary disease on PET/CT scan are significantly associated with poor OS in MM patients. The scale developed according to these predictors represents a potential prognostic tool for evaluation of patients with MM.
