Nakuz Thomas Selim, Millinger Filipe Portela, El-Rabadi Karem, Weber Michael, Pichler Verena, Wadsak Wolfgang, Mitterhauser Markus, Haug Alexander, Hacker Marcus, Karanikas Georgios, Pietschmann Peter, Agis Hermine
Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria.
Division of Radiology, Medical University of Vienna, Vienna, Austria.
Anticancer Res. 2019 Apr;39(4):1943-1952. doi: 10.21873/anticanres.13304.
The objective of this study was to characterize tumor activity and mineralization status in newly-detected multiple myeloma (MM) bone lesions using 2-F-fluoro-2-deoxy-D-glucose (F-FDG)-PET/CT and F-sodium fluoride (F-NaF)-PET/CT before and after antitumor treatment.
In this retrospective study, seven patients with histologically-verified MM were included (four women, three men; median age=57 years, standard deviation=11.23 years). PET/CT was performed with F-FDG and with F-NaF, both at baseline and after treatment. All patients had positive scans. Volumes of interest (VOIs) were drawn over all F-FDG-PET/CT-positive bone lesions, as well as the corresponding regions in F-NaF-PET/CT. For characterization of bone lesions, semi-quantitative standard uptake value (SUV) parameters were measured.
F-FDG-PET/CT in the seven patients detected 39 metabolically active lesions that were correlated with the corresponding sites in F-fluoride-PET/CT. Overall, the lesions showed a response to therapy, with a significant decrease in SUV on PET/CT using F-FDG (p<0.001) and with F-NaF (p<0.001). In four patients with a second follow-up scan (at a median of 17 months after baseline scan), there was no significant change in lesion uptake.
Based on our data, antitumor therapy in MM reduces not only tumor activity, but also the mineralization status of bone lesions. A second follow-up scan in a subset of the cohort yielded no change in mineralization status.
本研究的目的是利用2-氟-2-脱氧-D-葡萄糖（F-FDG）-PET/CT和氟氟化钠（F-NaF）-PET/CT，在抗肿瘤治疗前后对新发现的多发性骨髓瘤（MM）骨病变的肿瘤活性和矿化状态进行特征描述。
在这项回顾性研究中，纳入了7例经组织学证实的MM患者（4名女性，3名男性；中位年龄=57岁，标准差=11.23岁）。在基线期和治疗后均使用F-FDG和F-NaF进行PET/CT检查。所有患者的扫描结果均为阳性。在所有F-FDG-PET/CT阳性骨病变以及F-NaF-PET/CT的相应区域绘制感兴趣区（VOI）。为了对骨病变进行特征描述，测量了半定量标准摄取值（SUV）参数。
7例患者的F-FDG-PET/CT检测到39个代谢活跃病变，这些病变与氟化物-PET/CT的相应部位相关。总体而言，病变对治疗有反应，使用F-FDG（p<0.001）和F-NaF（p<0.001）的PET/CT上SUV显著降低。在4例进行第二次随访扫描的患者中（在基线扫描后中位17个月），病变摄取没有显著变化。
根据我们的数据，MM的抗肿瘤治疗不仅降低了肿瘤活性，还降低了骨病变的矿化状态。该队列中一部分患者的第二次随访扫描显示矿化状态没有变化。
