Role of 18 F-fluoride PET/CT in the assessment of multiple myeloma: initial experience
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SHORT COMMUNICATION
Role of 18F-fluoride PET/CT in the assessment of multiple myeloma: initial experience Yuji Nishiyama • Ukihide Tateishi • Kazuya Shizukuishi • Ayako Shishikura • Etsuko Yamazaki • Hiroto Shibata • Tomohiro Yoneyama • Yoshiaki Ishigatsubo • Tomio Inoue
Received: 7 June 2012 / Accepted: 29 July 2012 / Published online: 23 August 2012 Ó The Japanese Society of Nuclear Medicine 2012
Abstract Purpose The aim of this study was to report our early experience with 18F-fluoride PET/CT for detecting lesions and evaluate the usefulness of this modality in the assessment of multiple myeloma (MM). Materials and methods 18F-fluoride PET/CT and 99mTcMDP bone scintigraphy (BS) studies from 7 myeloma patients (4 male and 3 female, mean age 55 years) diagnosed according to standard criteria were reviewed retrospectively. Two reviewers visually and quantitatively analyzed the images and recorded their findings after reaching a consensus. Diagnostic certainty regarding the presence or absence of myeloma lesions was evaluated according to the reference standard consisting of wholebody magnetic resonance imaging and whole-body X-ray. Results A total of 93 affected areas were definite according to the reference standard. Of these, 83 affected areas (89 %) were identified on 18F-fluoride PET/CT, whereas 54 affected areas (58 %) were found on BS. Mean SUVmax in the affected areas was 9.8 ± 3.2 (standard deviation) ranging from 5.0 to 21.2. A total of s17 lesions with bone fracture were also detected by 18F-fluoride PET/ CT and 2 lesions (12 %) were negative on BS.
Y. Nishiyama U. Tateishi (&) K. Shizukuishi A. Shishikura H. Shibata T. Yoneyama T. Inoue Departments of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan e-mail: [email protected] E. Yamazaki Y. Ishigatsubo Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Conclusion Our result showed that 18F-fluoride PET was a possible modality to detect areas of lesions in patients with MM. Keywords Multiple myeloma 18F-fluoride NaF PET PET/CT Bone imaging
Introduction Multiple myeloma (MM) is a neoplastic monoclonal proliferation of plasma cells within the bone marrow. Osseous lesions in MM have been traditionally detected by wholebody radiographic survey. However, radiographs can significantly underestimate the extent of bone and bone marrow involvement, especially in the early phases of the disease [1]. Multiple imaging modalities including computed tomography (CT), magnetic resonance imaging (MRI), 99mTc-methylene diphosphonate (MDP) bone scintigraphy (BS), and positron emission tomography with 18 F-fluorodeoxyglucose (18F-FDG PET) have been introduced to depict skeletal lesions, but several problems remain to be resolved [2–4]. MRI sensitively detects infiltrative myeloma lesions, allowing direct visualization of the bone content with a high spatial resolution [5, 6]. However, MRI has a limitation in
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