FDG PET in Multiple Myeloma
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The potential of 18Fluoro-deoxyglucose (FDG) positron emission tomography (PET) for the treatment of multiple myeloma has recently been evaluated. FDG-PET is a powerful imaging tool for the detection of bone lesions at initial diagnosis with high sensitivity and specificity values. The presence of extra-medullary lesions affects the prognosis. During therapeutic evaluation, FDG-PET is the reference imaging technique, because it can be performed much earlier than an MRI which lacks specificity. The negativity of FDG-PET before and after autologous stem cell transplantation is an independent favorable prognostic factor, especially for patients with a complete biological response.
In patients with smoldering multiple myeloma, the presence of one or more hyper-metabolic lytic lesions on FDG-PET may be considered as a criterion for initiating therapy. In the event of a suspect solitary plasmacytoma, the completion of a PET-FDG is indicated so as to not disregard other bone or extra-medullary localizations. The challenge of future multi-center prospective studies will be to standardize the interpretation criteria of FDG-PET, especially in the therapeutic evaluation.
KeywordsMultiple myeloma FDG-PET/CT Review Prognosis
“This work has been supported in part by grants from the French National Agency for Research called “Investissements d’Avenir” IRON Labex n° ANR-11-LABX-0018-01 and ArronaxPlus Equipex n° ANR-11-EQPX-0004, and by a grant INCa-DGOS-Inserm_12558 (SIRIC ILIAD).”
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