TY - JOUR
T1 - Prognostic Impact of Metabolic Heterogeneity in Patients with Newly Diagnosed Multiple Myeloma Using 18F-FDG PET/CT
AU - Terao, Toshiki
AU - MacHida, Youichi
AU - Hirata, Kenji
AU - Kuzume, Ayumi
AU - Tabata, Rikako
AU - Tsushima, Takafumi
AU - Miura, Daisuke
AU - Narita, Kentaro
AU - Takeuchi, Masami
AU - Tateishi, Ukihide
AU - Matsue, Kosei
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - 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.
AB - 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.
KW - F-FDG PET
KW - metabolic heterogeneity
KW - MTV
KW - multiple myeloma
KW - SUV
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U2 - 10.1097/RLU.0000000000003773
DO - 10.1097/RLU.0000000000003773
M3 - Article
C2 - 34172600
AN - SCOPUS:85115641861
SN - 0363-9762
VL - 46
SP - 790
EP - 796
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
IS - 10
ER -