Prognostic Impact of Metabolic Heterogeneity in Patients with Newly Diagnosed Multiple Myeloma Using 18F-FDG PET/CT

Toshiki Terao, Youichi MacHida, Kenji Hirata, Ayumi Kuzume, Rikako Tabata, Takafumi Tsushima, Daisuke Miura, Kentaro Narita, Masami Takeuchi, Ukihide Tateishi, Kosei Matsue

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Purpose This study aimed to investigate the prognostic impact of metabolic heterogeneity (MH) in patients with multiple myeloma (MM). Patients and Methods We retrospectively analyzed MH with 18F-FDG PET/CT in 203 patients with newly diagnosed MM. Metabolic heterogeneity was estimated using the area under the curve of the cumulative SUV volume histogram. To evaluate MH, we selected 2 lesions: "MH-SUVmax,"a lesion with SUVmax, and "MH-metabolic tumor volume (MTV),"a lesion with the largest MTV. Results Metabolic heterogeneity from an MH-SUVmax lesion showed more prognostic relevance than that from a lesion with the largest MTV. The progression-free survival (PFS) and overall survival (OS) rates were significantly lower in the high-MH-SUVmax group than in the low-MH-SUVmax group (median PFS: 25.2 vs 33.9 months; median OS: 41.6 vs 112.0 months; P = 0.004 and 0.046, respectively), whereas high MH-SUVmax retained independent prognostic power on multivariate analysis. Even among patients with high whole-body MTV, those with high MH-SUVmax tended to show poorer prognosis than those without (median PFS, 23.8 vs 30.2 months; P = 0.085). Moreover, patients with high MH-SUVmax and high-risk cytogenetic abnormalities showed dismal outcomes even with standard treatment (median PFS and OS, 10.0 and 33.3 months, respectively). Conclusions Our results suggested that high MH-SUVmax based on pretreatment with 18F-FDG PET/CT is a novel prognostic factor for cases of MM.

Original languageEnglish
Pages (from-to)790-796
Number of pages7
JournalClinical Nuclear Medicine
Issue number10
Publication statusPublished - Oct 1 2021
Externally publishedYes


  • metabolic heterogeneity
  • MTV
  • multiple myeloma
  • SUV

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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