Sachpekidis Christos, Türk Matthias, Dimitrakopoulou-Strauss Antonia
Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg 69120, Germany.
Diagnostics (Basel). 2021 Apr 3;11(4):649. doi: 10.3390/diagnostics11040649.
We report on a 52-year-old patient with an initial diagnosis of smoldering myeloma (SMM), who was monitored by means of dynamic and static positron emission tomography/computed tomography (PET/CT) with the radiotracer ⁸F-fluorodeoxyglucose (F-FDG). Baseline PET/CT revealed no pathological signs. Six months later, a transition to symptomatic, multiple myeloma (MM) was diagnosed. The transition was not accompanied by focal, hypermetabolic lesions on PET/CT. However, a diffusely increased F-FDG uptake in the bone marrow, accompanied by a marked increase of semi-quantitative (standardized uptake value, SUV) and quantitative, pharmacokinetic F-FDG parameters, was demonstrated. After successful treatment, including tandem autologous transplantation, the diffuse uptake in the bone marrow as well as the semi-quantitative and quantitative parameters showed a marked remission. This response was also confirmed by the clinical follow-up of the patient. These findings suggest that in MM a diffuse F-FDG uptake in the bone marrow may indeed reflect an actual bone marrow infiltration by plasma cells. Moreover, SUV values and kinetic parameters, not only from myeloma lesions but also from random bone marrow samples, may be used for MM monitoring. This could be particularly helpful in the follow-up of myeloma patients negative for F-FDG-avid focal lesions.
我们报告了一名52岁最初诊断为冒烟型骨髓瘤（SMM）的患者，其通过使用放射性示踪剂⁸F-氟脱氧葡萄糖（F-FDG）的动态和静态正电子发射断层扫描/计算机断层扫描（PET/CT）进行监测。基线PET/CT未显示病理征象。6个月后，诊断为转变为有症状的多发性骨髓瘤（MM）。这种转变在PET/CT上并未伴有局灶性高代谢病变。然而，显示骨髓中F-FDG摄取弥漫性增加，同时半定量（标准化摄取值，SUV）和定量药代动力学F-FDG参数显著升高。在包括串联自体移植在内的成功治疗后，骨髓中的弥漫性摄取以及半定量和定量参数显示出明显缓解。患者的临床随访也证实了这种反应。这些发现表明，在MM中，骨髓中F-FDG的弥漫性摄取可能确实反映了浆细胞对骨髓的实际浸润。此外，SUV值和动力学参数，不仅来自骨髓瘤病变，也来自随机骨髓样本，可用于MM监测。这对于F-FDG摄取阳性局灶性病变阴性的骨髓瘤患者的随访可能特别有帮助。
