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Diagnostics 2017, 7(4), 61; https://doi.org/10.3390/diagnostics7040061

Functional Imaging with 18F-FDG PET/CT and Diffusion Weighted Imaging (DWI) in Early Response Evaluation of Combination Therapy of Elotuzumab, Lenalidomide, and Dexamethasone in a Relapsed Multiple Myeloma Patient

1
Medical PET Group-Biological Imaging Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Im Neuenheimer Feld 280, D-69210 Heidelberg, Germany
2
Department of Internal Medicine V, University Hospital Heidelberg, D-69210 Heidelberg, Germany
3
Department of Radiology, German Cancer Research Center (DKFZ), D-69210 Heidelberg, Germany
4
National Center for Tumor Diseases (NCT) Heidelberg, D-69210 Heidelberg, Germany
*
Author to whom correspondence should be addressed.
Received: 6 December 2017 / Revised: 13 December 2017 / Accepted: 14 December 2017 / Published: 15 December 2017
(This article belongs to the Section Medical Imaging)
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Abstract

Elotuzumab is the first monoclonal antibody approved for the treatment of relapsed-refractory multiple myeloma (MM) in combination with lenalidomide, an immunodulatory drug, and dexamethasone. We report on a multiply pre-treated MM patient with disease progression due to appearance of new focal lesions on imaging modalities, who was started on a combination treatment of elotuzumab, lenalidomide, and dexamethasone. After completion of three cycles of the new therapy the patient responded very well with a major decline of serological myeloma activity parameters serum monoclonal protein, kappa light chains, free light chains (FLC) ratio. The patient was also monitored with the functional imaging modalities 18F-FDG PET/CT and diffusion weighted imaging (DWI), which exhibited a mismatch of almost complete metabolic remission on positron emission tomography/computed tomography (PET/CT) with 18F-fluoro-2-deoxy-d-glucose (18F-FDG) (consistent with the serological response), and signal elevation persistence on DWI. This case demonstrates the potentially superior performance of 18F-FDG PET/CT over DWI in early response evaluation of combined treatment with a monoclonal antibody, an immunomodulatory drug, and dexamethasone in MM. View Full-Text
Keywords: multiple myeloma; elotuzumab; lenalidomide; 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT); diffusion weighted imaging (DWI) multiple myeloma; elotuzumab; lenalidomide; 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT); diffusion weighted imaging (DWI)
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Sachpekidis, C.; Dimitrakopoulou-Strauss, A.; Delorme, S.; Goldschmidt, H. Functional Imaging with 18F-FDG PET/CT and Diffusion Weighted Imaging (DWI) in Early Response Evaluation of Combination Therapy of Elotuzumab, Lenalidomide, and Dexamethasone in a Relapsed Multiple Myeloma Patient. Diagnostics 2017, 7, 61.

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