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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Differential Performances in Lesions and Radiotracer of 18F-FDG PET/CT between Multiple Myeloma and Unknown Osteolytic Metastasis

Author(s): Chengwen Deng, Dongyan Han, Xiaoying Zhang, Zhongwei Lv and Dan Li*

Volume 19, Issue 7, 2023

Published on: 26 September, 2022

Article ID: e160522204830 Pages: 7

DOI: 10.2174/1573405618666220516120230

Price: $65

Abstract

Purpose: The aim of the study was to investigate the differential performances in lesions and 18F-FDG radiotracer distribution detected by PET/CT between multiple myeloma and unknown osteolytic metastasis.

Methods: A retrospective study was performed on 18F-FDG PET/CT imaging of 63 patients with multiple bone destructions without extraosseous primary malignant tumors. By pathological diagnosis, 20 patients were confirmed to have multiple myeloma and 43 patients to have unknown osteolytic metastasis. The whole body was categorized into 8 sites: skull, spine, ribs, pelvis, sternum, clavicle, scapula and limb bone. The length of lesion cross-sections, cortical bone damage, SUVmax and radiotracer distribution were comprehensively compared to differentiate these two diseases.

Results: The cross-section lengths and SUVmax of the lesions in 5 sites (e.g., skull, spine, ribs, pelvis, and limb bone) were significantly shorter and lower in the multiple myeloma group than those of the unknown osteolytic metastasis group (P < 0.05). The 18F-FDG was more uniformly distributed in the lesion sites of the skull, spine, ribs, pelvis, scapula, and limb bone in the multiple myeloma group (P < 0.05). In the spine and rib lesion sites, the multiple myeloma group was more likely to show noncortical bone damage than the unknown osteolytic metastasis group (P < 0.05).

Conclusion: Differential observations in lesions and 18F-FDG distribution between multiple myeloma and unknown osteolytic metastasis were detected by comprehensively comparing the length of lesion cross-sections, cortical bone damage, SUVmax, and the distribution of radiotracer on18F-FDG PET/CT imaging.

Keywords: Multiple myeloma, osteolytic metastasis, positron emission computed tomography, cortical bone damage

[1]
Waheed S, Mitchell A, Usmani S, et al. Standard and novel imaging methods for multiple myeloma: Correlates with prognostic laboratory variables including gene expression profiling data. Haematologica 2013; 98(1): 71-8.
[http://dx.doi.org/10.3324/haematol.2012.066555] [PMID: 22733020]
[2]
Moulopoulos LA, Koutoulidis V, Hillengass J, et al. Recommendations for acquisition, interpretation and reporting of whole body low dose CT in patients with multiple myeloma and other plasma cell disorders: A report of the IMWG Bone Working Group. Blood Cancer J 2018; 8(10): 95-103.
[http://dx.doi.org/10.1038/s41408-018-0124-1] [PMID: 30287814]
[3]
von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: Current applications and future directions. Radiology 2006; 238(2): 405-22.
[http://dx.doi.org/10.1148/radiol.2382041977] [PMID: 16436809]
[4]
Ell PJ. The contribution of PET/CT to improved patient management. Br J Radiol 2006; 79(937): 32-6.
[http://dx.doi.org/10.1259/bjr/18454286] [PMID: 16421402]
[5]
M E, Juweid MD, D B. Positron-emission tomography and assessment of cancer therapy. N Engl J Med 2006; 354(5): 496-507.
[6]
Ormond Filho AG, Carneiro BC, Pastore D, et al. Whole-body imaging of multiple myeloma: Diagnostic criteria. Radiographics 2019; 39(4): 1077-97.
[http://dx.doi.org/10.1148/rg.2019180096] [PMID: 31283452]
[7]
Rasche L, Angtuaco EJ, Alpe TL, et al. The presence of large focal lesions is a strong independent prognostic factor in multiple myeloma. Blood 2018; 132(1): 59-66.
[http://dx.doi.org/10.1182/blood-2018-04-842880] [PMID: 29784643]
[8]
Ben-Haim S, Israel O. Breast cancer: Role of SPECT and PET in imaging bone metastases. Semin Nucl Med 2009; 39(6): 408-15.
[http://dx.doi.org/10.1053/j.semnuclmed.2009.05.002] [PMID: 19801220]
[9]
Rasche L, Angtuaco E, McDonald JE, et al. Low expression of hexokinase-2 is associated with false-negative FDG-positron emission tomography in multiple myeloma. Blood 2017; 130(1): 30-4.
[http://dx.doi.org/10.1182/blood-2017-03-774422] [PMID: 28432222]
[10]
Fonti R, Larobina M, Del Vecchio S, et al. Metabolic tumor volume assessed by 18F-FDG PET/CT for the prediction of outcome in patients with multiple myeloma. J Nuclear Med (1978) 2012; 53(12): 1829-35.
[11]
Abe Y, Narita K, Kobayashi H, et al. Medullary abnormalities in appendicular skeletons detected with 18F-FDG PET/CT predict an unfavorable prognosis in newly diagnosed multiple myeloma patients with high-risk factors. AJR Am J Roentgenol 2019; 213(4): 918-24.
[http://dx.doi.org/10.2214/AJR.19.21283] [PMID: 31216203]
[12]
Nanni C. PET-FDG: Impetus. Cancers (Basel) 2020; 12(4): 1030.
[http://dx.doi.org/10.3390/cancers12041030] [PMID: 32331374]
[13]
Yang M, Sun Y, Sun J, et al. Differentially expressed and survival-related proteins of lung adenocarcinoma with bone metastasis. Cancer Med 2018; 7(4): 1081-92.
[http://dx.doi.org/10.1002/cam4.1363] [PMID: 29522283]
[14]
Piccioli A, Maccauro G, Spinelli MS, Biagini R, Rossi B. Bone metastases of unknown origin: Epidemiology and principles of management. J Orthop Traumatol 2015; 16(2): 81-6.
[http://dx.doi.org/10.1007/s10195-015-0344-0] [PMID: 25726410]
[15]
Jacobsen S, Stephensen SL, Paaske BP, Lie PG, Lausten GS. Skeletal metastases of unknown origin: A retrospective analysis of 29 cases. Acta Orthop Belg 1997; 63(1): 15-22.
[PMID: 9151454]
[16]
Katagiri H, Takahashi M, Inagaki J, et al. Determining the site of the primary cancer in patients with skeletal metastasis of unknown origin: A retrospective study. Cancer 1999; 86: 533-7.
[17]
Shimada H, Setoguchi T, Yokouchi M, et al. Metastatic bone tumors: Analysis of factors affecting prognosis and efficacy of CT and 18F-FDG PET-CT in identifying primary lesions. Mol Clin Oncol 2014; 2(5): 875-81.
[http://dx.doi.org/10.3892/mco.2014.326] [PMID: 25054061]
[18]
Takagi T, Katagiri H, Kim Y, et al. Skeletal metastasis of unknown primary origin at the initial visit: A retrospective analysis of 286 cases. PLoS One 2015; 10(6): e0129428.
[http://dx.doi.org/10.1371/journal.pone.0129428] [PMID: 26115010]
[19]
Evangelista L, Panunzio A, Polverosi R, et al. Early bone marrow metastasis detection: The additional value of FDG-PET/CT vs. CT imaging. Biomed Pharmacother 2012; 66(6): 448-53.
[http://dx.doi.org/10.1016/j.biopha.2012.06.004] [PMID: 22902054]
[20]
Israel O, Goldberg A, Nachtigal A, et al. FDG-PET and CT patterns of bone metastases and their relationship to previously administered anti-cancer therapy. Eur J Nucl Med Mol Imaging 2006; 33(11): 1280-4.
[http://dx.doi.org/10.1007/s00259-006-0141-3] [PMID: 16791597]
[21]
Bocci F, Gearhart-Serna L, Boareto M, et al. Toward understanding cancer stem cell heterogeneity in the tumor microenvironment. Proc Natl Acad Sci USA 2019; 116(1): 148-57.
[http://dx.doi.org/10.1073/pnas.1815345116] [PMID: 30587589]
[22]
Hortobagyi GN. Progress in the management of bone metastases: One continent at a time? J Clin Oncol 2005; 23(15): 3299-301.
[http://dx.doi.org/10.1200/JCO.2005.11.931] [PMID: 15738530]
[23]
Gainford MC, Dranitsaris G, Clemons M. Systemic treatment of bone metastases from breast cancer: Is it all that it’s cracked up to be? J Clin Oncol 2005; 23(21): 4802-3.
[http://dx.doi.org/10.1200/JCO.2005.01.3490] [PMID: 16034064]

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