Istanbul Medical Faculty, Department of Nuclear Medicine, Istanbul, Turkey.
Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey.
Ann Nucl Med. 2021 Oct;35(10):1147-1156. doi: 10.1007/s12149-021-01652-1. Epub 2021 Jun 29.
This study investigates the prognostic value of Ga-Pentixafor PET/CT using PET-derived quantitative in multiple myeloma (MM) patients with suspected recurrence in comparison to F-FDG PET/CT and clinical data.
Twenty-four MM patients with suspicion for relapse who underwent Ga-Pentixafor and F-FDG PET/CT were retrospectively evaluated. Total bone marrow glycolysis for F-FDG (TBM) and total bone marrow uptake for Ga-Pentixafor PET/CT (TBM) were calculated using whole-body metabolic tumor burden obtained by dedicated software (MIM 7.0.6). The patients were followed for 19-24 months, and the association of PET-derived quantitative data with overall survival (OS) was analyzed.
Ga-Pentixafor PET/CT was positive in 17 patients, of which 13 were also positive on F-FDG PET/CT, whereas 7 patients were negative on both scans. The positive rate of Ga-Pentixafor and F-FDG PET/CT on a patient-based approach was 70.8% and 54.1%, respectively. Ga-Pentixafor positivity was significantly associated with OS (p = 0.009), and F-FDG positivity was at the margin of statistical significance (p = 0.056). TBM and TBM were negatively correlated with OS (r = -0.457, p = 0.025 and r = -0.617, p = 0.001, respectively). The OS was negatively correlated with beta-2-microglobulin levels (r = -0.511, p = 0.01) and CRAB score (r = -0.592, p = 0.002) as an indicator of the end-organ disease, which confirmed these results. Serum beta-2-microglobulin levels and CRAB score were also correlated with TBM (r = 0.442, p = 0.039 and r = 0.573, p = 0.003, respectively) and TBM (r = 0.543, p = 0.009 and r = -0.424, p = 0.003, respectively).
Ga-Pentixafor PET/CT positivity is a negative prognostic factor in the survival outcome of MM patients. Complementary Ga-Pentixafor PET/CT has the potential to overcome F-FDG PET/CT limitations and helps a more precise risk stratification.
本研究旨在探讨 Ga- Pentixafor PET/CT 相对于 F-FDG PET/CT 和临床数据在多发性骨髓瘤（MM）患者中用于检测疑似复发的预后价值。
回顾性分析了 24 例疑似复发的 MM 患者，这些患者接受了 Ga- Pentixafor 和 F-FDG PET/CT 检查。使用专用软件（MIM 7.0.6）获得全身代谢肿瘤负荷，计算 F-FDG（TBM）的总骨髓糖酵解和 Ga- Pentixafor PET/CT（TBM）的总骨髓摄取。对患者进行了 19-24 个月的随访，并分析了 PET 衍生的定量数据与总生存（OS）的相关性。
Ga- Pentixafor PET/CT 在 17 例患者中呈阳性，其中 13 例 F-FDG PET/CT 也呈阳性，而 7 例患者两种扫描均呈阴性。基于患者的 Ga- Pentixafor 和 F-FDG PET/CT 的阳性率分别为 70.8%和 54.1%。Ga- Pentixafor 阳性与 OS 显著相关（p=0.009），F-FDG 阳性则接近统计学意义（p=0.056）。TBM 和 TBM 与 OS 呈负相关（r=-0.457，p=0.025 和 r=-0.617，p=0.001）。OS 与β-2-微球蛋白水平（r=-0.511，p=0.01）和 CRAB 评分（r=-0.592，p=0.002）呈负相关，这是终末器官疾病的指标，证实了这些结果。血清β-2-微球蛋白水平和 CRAB 评分与 TBM（r=0.442，p=0.039 和 r=0.573，p=0.003）和 TBM（r=0.543，p=0.009 和 r=-0.424，p=0.003）呈正相关。
Ga- Pentixafor PET/CT 阳性是 MM 患者生存结果的负预后因素。补充 Ga- Pentixafor PET/CT 有可能克服 F-FDG PET/CT 的局限性，有助于更精确的风险分层。
