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PET-FDG: Impetus
Open AccessArticle

18F-FDG and 11C-Methionine PET/CT in Newly Diagnosed Multiple Myeloma Patients: Comparison of Volume-Based PET Biomarkers

1
Department of Nuclear Medicine, University Clinic of Navarra, Center of Applied Medical Research (CIMA), Navarra Institute for Health Research (IDISNA), 31008 Pamplona, Spain
2
Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
3
Department of Hematology, University Clinic of Navarra, CIMA, CIBERONC, IDISNA, 31008 Pamplona, Spain
4
Department of Internal Medicine II, University Hospital Würzburg, 97080 Würzburg, Germany
5
Nuclear Medicine, Medical Faculty, University of Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Cancers 2020, 12(4), 1042; https://doi.org/10.3390/cancers12041042
Received: 30 March 2020 / Revised: 16 April 2020 / Accepted: 21 April 2020 / Published: 23 April 2020
(This article belongs to the Special Issue PET/CT in Multiple Myeloma Patients)
11C-methionine (11C-MET) is a new positron emission tomography (PET) tracer for the assessment of disease activity in multiple myeloma (MM) patients, with preliminary data suggesting higher sensitivity and specificity than 18F-fluorodeoxyglucose (18F-FDG). However, the value of tumor burden biomarkers has yet to be investigated. Our goals were to corroborate the superiority of 11C-MET for MM staging and to compare its suitability for the assessment of metabolic tumor burden biomarkers in comparison to 18F-FDG. Twenty-two patients with newly diagnosed, treatment-naïve symptomatic MM who had undergone 11C-MET and 18F-FDG PET/CT were evaluated. Standardized uptake values (SUV) were determined and compared with total metabolic tumor volume (TMTV) for both tracers: total lesion glycolysis (TLG) and total lesion 11C-MET uptake (TLMU). PET-derived values were compared to Revised International Staging System (R-ISS), cytogenetic, and serologic MM markers such as M component, beta 2 microglobulin (B2M), serum free light chains (FLC), albumin, and lactate dehydrogenase (LDH). In 11 patients (50%), 11C-MET detected more focal lesions (FL) than FDG (p < 0.01). SUVmax, SUVmean, SUVpeak, TMTV, and TLMU were also significantly higher in 11C-MET than in 18F-FDG (p < 0.05, respectively). 11C-MET PET biomarkers had a better correlation with tumor burden (bone marrow plasma cell infiltration, M component; p < 0.05 versus p = n.s. respectively). This pilot study suggests that 11C-MET PET/CT is a more sensitive marker for the assessment of myeloma tumor burden than 18F-FDG. Its implications for prognosis evaluation need further investigation. View Full-Text
Keywords: multiple myeloma; methionine; total lesion glycolysis (TLG); metabolic tumor volume (MTV); total lesion methionine uptake (TLMU) multiple myeloma; methionine; total lesion glycolysis (TLG); metabolic tumor volume (MTV); total lesion methionine uptake (TLMU)
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Morales-Lozano, M.I.; Viering, O.; Samnick, S.; Rodriguez-Otero, P.; Buck, A.K.; Marcos-Jubilar, M.; Rasche, L.; Prieto, E.; Kortüm, K.M.; San-Miguel, J.; Garcia-Velloso, M.J.; Lapa, C. 18F-FDG and 11C-Methionine PET/CT in Newly Diagnosed Multiple Myeloma Patients: Comparison of Volume-Based PET Biomarkers. Cancers 2020, 12, 1042.

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