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• W2985107792 abstract "1126 Objectives: Multiple myeloma (MM) is a hematological malignancy affecting plasma cells. The International Myeloma Working Group (IMWG) has recently updated its guidelines recommending the use of more sophisticated imaging modalities such as PET, which offers earlier detection of the osteolytic lesions as well as more accurate management of MM patients. In this educational abstract, we aim to introduce various novel concepts of PET imaging in MM developed through the joint collaboration between the University of Pennsylvania (Perelman School of Medicine) and the University of Southern Denmark (Odense University Hospital): 1- GSUVmean: Despite its promising role, quantification of PET in MM patients lacks standardization and, thus, some of previous studies have experienced poor inter- and intra-observer reproducibility that hampers the routine use of this imaging modality in MM patients. We will introduce a novel PET/CT method for quantification of whole bone marrow FDG uptake and whole osseous NaF uptake in MM patients. After the co-registration of the PET and CT data, we applied a threshold algorithm based on the CT Hounsfield scale, which allowed us to segment and quantify the FDG and NaF uptake in the entire skeleton of the patients. This was expressed as the global mean standardized uptake value (GSUVmean). Our results showed a higher uptake of FDG and NaF in the bone marrow and bone of MM patients in comparison to healthy subjects. 2- Dual Time Point Imaging (DTPI): DTPI is a concept that has been scarcely applied to MM patients. We assessed the change in FDG uptake in focal lesions as well as whole bone marrow of MM patients from 1 hour to 3 hours after FDG injection (ROVER; ABX, Radeberg, Germany and OsiriX software; Pixmeo, Bernex, Switzerland). Higher increases in FDG uptake in both focal lesions and whole bone marrow were associated with worse prognoses. 3- Assessment of atherosclerosis: MM patients have a higher prevalence of cardiovascular disease than healthy population. We used NaF as an early indicator of atherosclerosis to assess the degree of thoracic aorta atherosclerosis in MM patients. We assigned regions of interest on NaF PET/CT images in the ascending aorta, aortic arch and descending aorta of patients and compared the aortic SUVmeans with those of the healthy control subjects and found significantly higher NaF uptakes in all three aortic segments in MM patients compared to controls. This preliminary result showed that NaF-PET/CT can become a valuable modality in assessing atherosclerotic disease burden in MM patients. 4- Chemo-brain: We evaluated the effects of chemotherapy on cerebral glucose metabolism in MM patients and found significant decreases in the FDG uptake in the cerebrum, cerebellum and whole brain of the patients who had received high dose chemotherapy. Conclusions: The routine use of PET/CT in MM patients is still hampered mainly by the lack of standardized imaging criteria, resulting in poor inter- and intra-observer reproducibility for interpretation of PET images. We believe the mentioned novel semi-automated method of quantification is able to overcome such deficiencies regarding the poor reproducibility of PET quantification in MM patients. We also introduced three relatively new aspects of PET-based evaluation of MM patients: DTPI, assessment of atherosclerosis with NaF and chemo-brain." @default.
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• W2985107792 date "2019-05-01" @default.
• W2985107792 modified "2023-10-14" @default.
• W2985107792 title "Emerging techniques for assessment of multiple myeloma patients with PET/CT using FDG and NaF" @default.
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