PET/CT with 18F-fluorodeoxyglucose and 11C-methionine after autologous stem cell transplantation in multiple myeloma patients


Cite item

Full Text

Abstract

Aim: to compare the results of tumor visualization when using 18F-FDG and 11C-methionine PET/CT after auto-HSCT in MM patients. Materials and methods. A prospective study included 27 MM patients subjected to 18F-FDG and 11C-methionine PET/CT on day 100 after auto-HSCT. Obtained images were visually and semi - quantitatively analyzed. Focal areas of increased uptake for every radiopharmaceutical agent (hypermetabolic foci) not associated with its physiological distribution were registered. Maximum Standardized Uptake Values (SUVmax) in pathological foci were automatically calculated for every radiopharmaceutical agent separately. PET/CT findings were compared to antitumor response achieved after auto-HSCT according to International MM Working Group criteria. Results. After auto-HSCT, the majority of patients (16/60%) achieved a complete response. Abnormal 18F-FDG uptake was registered in 37% (n=10) of patients, negative PET findings were obtained in 63% (n=17) of patients. 11C-methionine PET/CT revealed hypermetabolic foci in 67% (n=18) of patients, and there was no 11C-methionine uptake in 33% (n=9). Pathological foci of radiopharmaceutical agent uptake were 1.8 times more frequently revealed using PET/CT with 11C-methionine (p<0.02). The mean SUVmax for 18F-FDG was 1.02, whereas the mean SUVmax for 11C-methionine was 2.29. The SUVmax value for 11C-methionine significantly exceeded that for 18F-FDG (р=0.02). Conclusion. 11C-methionine PET/CT was superior to 18F-FDG overcoming its limitations and increasing the tumor detection rate in bone marrow in MM patients after auto-HSCT.

About the authors

M V Solovev

National Research Center for Hematology

Email: maxsolovej@mail.ru
врач-гематолог, зав. отд-нием интенсивной высокодозной химиотерапии парапротеинемических гемобластозов ФГБУ «НМИЦ гематологии» Минздрава России; ORCID: 0000-0002-7944-6202 Moscow, Russia

L P Mendeleeva

National Research Center for Hematology

д.м.н., проф., зам. генерального директора по научной работе и инновациям ФГБУ «НМИЦ гематологии» Минздрава России; ORCID: 0000-0002-4966-8146 Moscow, Russia

M V Firsova

National Research Center for Hematology

н.с. отд-ния интенсивной высокодозной химиотерапии парапротеинемических гемобластозов ФГБУ «НМИЦ гематологии» Минздрава России; ORCID: 0000-0003-4142-171X Moscow, Russia

I P Aslanidi

Bakoulev Scientific Center for Cardiovascular Surgery

д.м.н., зав. отд. ядерной диагностики с ПЭТ-центром ФГБУ «НМИЦ сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России; ORCID: 0000-0001-6386-2378 Moscow, Russia

O V Mukhortova

Bakoulev Scientific Center for Cardiovascular Surgery

д.м.н., с.н.с. отд. ядерной диагностики с ПЭТ-центром ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России; ORCID: 0000-0002-7716-5896 Moscow, Russia

V G Savchenko

National Research Center for Hematology

акад. РАН, д.м.н., проф., генеральный директор ФГБУ «НМИЦ гематологии» Минздрава России; ORCID: 0000-0001-8188-5557 Moscow, Russia

References

  1. Лучинин А.С., Семочкин С.В., Минаева Н.В., Поздеев Н.М., Парамонов И.В. Эпидемиология множественной миеломы по данным анализа популяционного регистра Кировской области. Онкогематология. 2017;12(3):50-6. doi: 10.17650/1818-8346-2017-12-3-50-56
  2. Поспелова Т.И., Скворцова Н.В., Нечунаева И.Н. Множественная миелома: 7 лет таргетной терапии и ее результаты в Новосибирске. Клиническая онкогематология. 2015;8(3):267-73. http://bloodjournal.ru/wp-content/uploads/2015/11/4-Stra nitsy-iz-ONCO_3_20151-4.pdf
  3. Dimopoulos M.A, Leleu X, Palumbo A, Moreau P, Delforge M, Cavo M, Ludwig H, Morgan G.J, Davies F.E, Sonneveld P, Schey S.A, Zweegman S, Hansson M, Weisel K, Mateos M.V, Facon T, Miguel J.F. Expert panel consensus statement on the optimal use of pomalidomide in relapsed and refractory multiple myeloma. Leukemia. 2014;28(8):1573-85. doi: 10.1038/leu.2014.60
  4. Dytfeld D, Jasielec J, Griffith K.A, Lebovic D, Vesole D.H, Jagannath S, Al-Zoubi A, Anderson T, Detweiler-Short K, Stockerl-Goldstein K, Ahmed A, Jobkar T, Durecki D.E, McDonnell K, Mietzel M, Couriel D, Kaminski M, Vij R, Jakubowiak A.J. Carfilzomib, lenalidomide, and low - dose dexamethasone in elderly patients with newly diagnosed multiple myeloma. Haematologica. 2014; 99(9):162-4. doi: 10.3324/haematol.2014.110395
  5. Gay F, Oliva S, Petrucci M.T, Montefusco V, Conticello C, Musto P, Catalano L, Evangelista A, Spada S, Campbell P, Ria R, Salvini M, Offidani M, Carella A.M, Omedé P, Liberati A.M, Troia R, Cafro A.M, Malfitano A, Falcone A.P, Caravita T, Patriarca F, Nagler A, Spencer A, Hajek R, Palumbo A, Boccadoro M. Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients: a pooled analysis. Leukemia. 2017;31(8):1727-34. doi: 10.1038/leu.2016.381
  6. Lonial S, Vij R, Harousseau J.L, Facon T, Moreau P, Mazumder A, Kaufman J.L, Leleu X, Tsao L.C, Westland C, Singhal A.K, Jagannath S. Elotuzumab in combination with lenalidomide and low - dose dexamethasone in relapsed or refractory multiple myeloma. J Clin Oncol. 2012;30(16):1953-9. doi: 10.1200/JCO.2011.37.2649
  7. Lonial S, Weiss B.M, Usmani S.Z, Singhal S, Chari A, Bahlis N.J, Belch A, Krishnan A, Vescio R.A, Mateos M.V, Mazumder A, Orlowski R.Z, Sutherland H.J, Bladé J, Scott E.C, Oriol A, Berdeja J, Gharibo M, Stevens D.A, Le Blanc R, Sebag M, Callander N, Jakubowiak A, White D, de la Rubia J, Richardson P.G, Lisby S, Feng H, Uhlar C.M, Khan I, Ahmadi T, Voorhees P.M. Daratumumab monotherapy in patients with treatment - refractory multiple myeloma (SIRIUS): an open - label, randomised, phase 2 trial. Lancet. 2016;387(10027):1551-60. doi: 10.1016/S0140-6736(15)01120-4
  8. Moreau P, San Miguel J, Sonneveld P, Mateos M.V, Zamagni E, Avet-Loiseau H, Hajek R, Dimopoulos M.A, Ludwig H, Einsele H, Zweegman S, Facon T, Cavo M, Terpos E, Goldschmidt H, Attal M, Buske C; ESMO Guidelines Committee. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow - up. Ann Oncol. 2017;28(suppl 4):iv52-iv61. doi: 10.1093/ annonc/mdx096
  9. Richardson P.G, Hofmeister C.C, Raje N.S, Siegel D.S, Lonial S, Laubach J, Efebera Y.A, Vesole D.H, Nooka A.K, Rosenblatt J, Doss D, Zaki M.H, Bensmaine A, Herring J, Li Y, Watkins L, Chen M.S, Anderson K.C. Pomalidomide, bortezomib and low - dose dexamethasone in lenalidomide - refractory and proteasome inhibitor - exposed myeloma. Leukemia. 2017;31(12):2695-701. doi: 10.1038/leu.2017.173
  10. Roussel M, Lauwers-Cances V, Robillard N, Hulin C, Leleu X, Benboubker L, Marit G, Moreau P, Pegourie B, Caillot D, Fruchart C, Stoppa A-M.M, Gentil C, Wuilleme S, Huynh A, Hebraud B, Corre J, Chretien M-L.L, Facon T, Avet-Loiseau H, Attal M. Front - line transplantation program with lenalidomide, bortezomib, and dexamethasone combination as induction and consolidation followed by lenalidomide maintenance in patients with multiple myeloma: a phase II study by the Intergroupe Francophone du Myélo. J Clin Oncol. 2014;32(25):2712-7. doi: 10.1200/JCO.2013.54.8164
  11. Usmani S.Z, Diels J, Ito T, Mehra M, Khan I, Lam A. Daratumumab monotherapy compared with historical control data in heavily pretreated and highly refractory patients with multiple myeloma: An adjusted treatment comparison. Am J Hematol. 2017;92(8):E146-E152. doi: 10.1002/ajh.24781
  12. Kaatsch P, Spix C, Hentschel S, Katalinic A, Luttmann S, Stegmaier C. Cancer in Germany. 2009/2010. Berlin, 2014:16-18.
  13. Myeloma Statistics American Cancer Society - Cancer Facts &. Accessed May 15, 2018. https://cancerstatisticscenter.cancer.org/#!/cancer-site/Myeloma
  14. Mendeleeva L.P. Multiple Myeloma in Russia (First Results of the Registration Trial). Blood. 2017;130(1):5408. Accessed March 20, 2019. http://www.bloodjournal.org/content/130/Suppl_1/5408?sso-checked= true
  15. Городецкий В.Р., Пробатова Н.А., Васильев В.И., Мухортова О.В., Асланиди И.П., Сидорова Ю.В., Рыжикова Н.В., Раденска-Лоповок С.Г., Егорова О.Н. Подкожная панникулитоподобная Т-клеточная лимфома. Собственный опыт в диагностике и лечении. Терапевтический архив. 2016;88(7):49-55. doi: 10.17116/terarkh201688749-55
  16. Демина Е.А., Леонтьева А.А., Тумян Г.С., Рябухина Ю.Е., Медведовская Е.Г., Трофимова О.П., Сотников В.М., Ларионова В.Б., Парамонова Е.В., Манзюк Л.В., Кокосадзе Н.В., Мухортова О.В., Асланиди И.П., Зайцева А.Ю., Радкевич Л.А., Рудас М.С., Манукова В.А., Османов Е.А. Значение позитронно - эмиссионной томографии в оптимизации терапии распространенных стадий лимфомы Ходжкина с использованием интенсивной программы ЕАСОРР-14. Клиническая онкогематология. 2017;10(2):150-7. doi: 10.21320/2500-2139-2017-10-2-150-157
  17. Kostakoglu L, Cheson B.D. State - of - the-Art Research on “Lymphomas: Role of Molecular Imaging for Staging, Prognostic Evaluation, and Treatment Response”. Front Oncol. 2013;3(212). doi: 10.3389/fonc.2013.00212
  18. Meignan M, Hutchings M, Schwartz L.H. Imaging in Lymphoma: The Key Role of Fluorodeoxyglucose-Positron Emission Tomography. Oncologist. 2015;20(8):890-5. doi: 10.1634/theoncologist.2015-0036
  19. Bailly C, Leforestier R, Jamet B, Carlier T, Bourgeois M, Guérard F, Touzeau C, Moreau P, Chérel M, Kraeber-Bodéré F, Bodet-Milin C. PET Imaging for Initial Staging and Therapy Assessment in Multiple Myeloma Patients. Int J Mol Sci. 2017;18(2):445. doi: 10.3390/ijms18020445
  20. Mukhortova О, Aslanidis I, Katunina T, Rumjantzev A, Silchenkov A, Solovev M, Mendeleeva L. PET/CT with 18F-FDG and 11C-methionine for assessment of remission status after autologous stem cell transplantation in multiple myeloma patients. Eur J Nucl Med Mol Imaging. 2017;44:383-4.
  21. Usmani S.Z, Mitchell A, Waheed S, Crowley J, Hoering A, Petty N, Brown T, Bartel T, Anaissie E, van Rhee F, Barlogie B. Prognostic implications of serial 18-fluoro - deoxyglucose emission tomography in multiple myeloma treated with total therapy 3. Blood. 2013;121(10):1819-23. doi: 10.1182/blood-2012-08-451690
  22. Rajkumar S.V, Dimopoulos M.A, Palumbo A, Blade J, Merlini G, Mateos M.V, Kumar S, Hillengass J, Kastritis E, Richardson P, Landgren O, Paiva B, Dispenzieri A, Weiss B, Le Leu X, Zweegman S, Lonial S, Rosinol L, Zamagni E, Jagannath S, Sezer O, Kristinsson S.Y, Caers J, Usmani S.Z, Lahuerta J.J, Johnsen H.E, Beksac M, Cavo M, Goldschmidt H, Terpos E, Kyle R.A, Anderson K.C, Durie B.G, Miguel J.F. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):538-48. doi: 10.1016/S1470-2045(14)70442-5
  23. Bartel T.B, Haessler J, Brown T.L, Shaughnessy J.D. Jr, van Rhee F, Anaissie E, Alpe T, Angtuaco E, Walker R, Epstein J, Crowley J, Barlogie B. F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood. 2009;114(10):2068-76. doi: 10.1182/blood-2009-03-213280
  24. Fonti R, Pace L, Cerchione C, Catalano L, Salvatore B, De Luca S, Pane F, Salvatore M, Del Vecchio S. 18F-FDG PET/CT, 99mTc-MIBI, and MRI in the Prediction of Outcome of Patients With Multiple Myeloma. Clin Nucl Med. 2015;40(4):303-8. doi: 10.1097/RLU.0000000000000696
  25. Haznedar R, Akı S.Z, Akdemir O.U, Ozkurt Z.N, Ceneli O, Yağcı M, Sucak G.T, Unlü M. Value of 18F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma. Eur J Nucl Med Mol Imaging. 2011;38(6):1046-53. doi: 10.1007/s00259-011-1738-8
  26. Zamagni E, Patriarca F, Nanni C, Zannetti B, Englaro E, Pezzi A, Tacchetti P, Buttignol S, Perrone G, Brioli A, Pantani L, Terragna C, Carobolante F, Baccarani M, Fanin R, Fanti S, Cavo M. Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up - front autologous transplantation. Blood. 2011;118(23):5989-95. doi: 10.1182/blood-2011-06-361386
  27. Cavo M, Terpos E, Nanni C, Moreau P, Lentzsch S, Zweegman S, Hillengass J, Engelhardt M, Usmani S.Z, Vesole D.H, San-Miguel J, Kumar S.K, Richardson P.G, Mikhael J.R, da Costa F.L, Dimopoulos M.A, Zingaretti C, Abildgaard N, Goldschmidt H, Orlowski R.Z, Chng W.J, Einsele H, Lonial S, Barlogie B, Anderson K.C, Rajkumar S.V, Durie B.G.M, Zamagni E. Role of 18F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group. Lancet Oncol. 2017;18(4):206-17. doi: 10.1016/S1470-2045(17)30189-4
  28. Lapa C, Garcia-Velloso M.J, Lückerath K, Samnick S, Schreder M, Otero P.R, Schmid J-S, Herrmann K, Knop S, Buck A.K, Einsele H, San-Miguel J, Kortüm K.M. 11C-Methionine-PET in Multiple Myeloma: A Combined Study from Two Different Institutions. Theranostics. 2017;7(11):2956-64. doi: 10.7150/thno.20491
  29. Kumar S, Paiva B, Anderson K.C, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos M.V, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Goldschmidt H, Spencer A, Hou J, Chng W.J, Usmani S.Z, Zamagni E, Shimizu K, Jagannath S, Johnsen H.E, Terpos E, Reiman A, Kyle R.A, Sonneveld P, Richardson P.G, Mc Carthy P, Ludwig H, Chen W, Cavo M, Harousseau J.L, Lentzsch S2, Hillengass J1, Palumbo A, Orfao A, Rajkumar S.V, Miguel J.S. Avet-Loiseau H30International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17(8):328-46. doi: 10.1016/S1470-2045(16)3020 6-6
  30. Hillengass J, Landgren O. Challenges and opportunities of novel imaging techniques in monoclonal plasma cell disorders: imaging “early myeloma”. Leuk Lymphoma. 2013;54(7):1355-63. doi: 10.3109/ 10428194.2012.740559
  31. Zamagni E, Nanni C, Patriarca F, Englaro E, Castellucci P, Geatti O, Tosi P, Tacchetti P, Cangini D, Perrone G, Ceccolini M, Brioli A, Buttignol S, Fanin R, Salizzoni E, Baccarani M, Fanti S, Cavo M. A prospective comparison of 18F-fluorodeoxyglucose positron emission tomography - computed tomography, magnetic resonance imaging and whole - body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma. Haematologica. 2007;92(1):50-5.
  32. Lückerath K, Lapa C, Spahmann A, Jörg G, Samnick S, Rosenwald A, Einsele H, Knop S, Buck A.K. Targeting paraprotein biosynthesis for non - invasive characterization of myeloma biology. PLoS One. 2013;8(12):84840. https://opus.bibliothek.uni-wuerzburg.de/opus4 wuerzburg/frontdoor/deliver/index/doc Id/11131/file/ 024_Lueckerath_PLoS.pdf

Copyright (c) 2019 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies