Molecular Imaging and Therapy and Interventional Radiology Services, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Bone. 2024 Feb;179:116957. doi: 10.1016/j.bone.2023.116957. Epub 2023 Nov 14.
Over 80 % of patients with multiple myeloma (MM) experience osteolytic bone lesions, primarily due to an imbalanced interaction between osteoclasts and osteoblasts. This imbalance can lead to several adverse outcomes such as pain, fractures, limited mobility, and neurological impairments. Myeloma bone disease (MBD) raises the expense of management in addition to being a major source of disability and morbidity in myeloma patients. Whole-body x-ray radiography was the gold standard imaging modality for detecting lytic lesions. Osteolytic lesions are difficult to identify at an earlier stage on X-ray since the lesions do not manifest themselves on conventional radiographs until at least 30 % to 50 % of the bone mass has been destroyed. Hence, early diagnosis of osteolytic lesions necessitates the utilization of more complex and advanced imaging modalities, such as PET. One of the PET radiotracers that has been frequently investigated in MM is F-FDG, which has demonstrated a high level of sensitivity and specificity in detecting myeloma lesions. However, F-FDG PET/CT has several restrictions, and therefore the novel PET tracers that can overcome the limitations of F-FDG PET/CT should be further examined in assessment of MBD. The objective of this review article is to thoroughly examine the significance of both conventional and novel PET radiotracers in the assessment of MBD. The intention is to present the information in a manner that would be easily understood by healthcare professionals from diverse backgrounds, while minimizing the use of complex nuclear medicine terminology.
超过 80%的多发性骨髓瘤 (MM) 患者存在溶骨性骨病变，主要是由于破骨细胞和成骨细胞之间的失衡相互作用所致。这种失衡可导致多种不良后果，如疼痛、骨折、活动受限和神经损伤。骨髓瘤骨病 (MBD) 不仅是骨髓瘤患者残疾和发病的主要原因，还增加了管理成本。全身 X 射线摄影是检测溶骨性病变的金标准成像方式。溶骨性病变在 X 射线上很难在早期识别，因为在骨量至少被破坏 30%到 50%之前，病变不会在常规 X 光片上显现出来。因此，溶骨性病变的早期诊断需要使用更复杂和先进的成像方式，如 PET。在 MM 中经常研究的一种 PET 放射性示踪剂是 F-FDG，它在检测骨髓瘤病变方面具有很高的灵敏度和特异性。然而，F-FDG PET/CT 存在一些限制，因此，应该进一步研究可以克服 F-FDG PET/CT 局限性的新型 PET 示踪剂，以评估 MBD。本文的目的是全面检查常规和新型 PET 放射性示踪剂在评估 MBD 中的意义。我们希望以一种易于理解的方式呈现信息，同时尽量减少使用复杂的核医学术语。
