Chen Zhenying, Yang Apeng, Chen Aihong, Dong Jinfeng, Lin Junfang, Huang Chao, Zhang Jiaying, Liu Huimin, Zeng Zhiyong, Miao Weibing
Department of Nuclear Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
Department of Nuclear Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
Eur J Nucl Med Mol Imaging. 2024 Jun;51(7):1926-1936. doi: 10.1007/s00259-024-06621-0. Epub 2024 Jan 30.
To evaluate the prognostic performance of [Ga]Pentixafor PET/CT at baseline for staging of patients with newly diagnosed multiple myeloma (MM) and to compare it with [F]FDG PET/CT and the Revised-International Staging System (R-ISS).
Patients who underwent [Ga]Pentixafor and [F]FDG PET/CT imaging were retrospectively included. Patient staging was performed according to the Durie-Salmon PLUS staging system based on [Ga]Pentixafor PET/CT and [F]FDG PET/CT images, and the R-ISS. Progression-free survival (PFS) at patient follow-up was estimated using the Kaplan-Meier estimator and compared using the log-rank test. Area under the receiver operating characteristic curve (AUC) was calculated to assess predictive performance.
Fifty-five MM patients were evaluated. Compared with [F]FDG PET, [Ga]Pentixafor PET detected 25 patients as the same stage, while 26 patients were upstaged and 4 patients were downstaged (P = 0.001). After considering the low-dose CT data, there was no statistically significant difference in the number of patients classified in each stage using [Ga]Pentixafor PET/CT and [F]FDG PET/CT (P = 0.091). [Ga]Pentixafor PET/CT-based staging discriminated PFS outcomes in patients with different disease stages (stage I vs. stage II, stage I vs. stage III, and stage II vs. stage III; all P < 0.05), whereas for [F]FDG PET/CT, there was only a difference in median PFS between stage I and III (P = 0.021). When staged by R-ISS, the median PFS for stage III was significantly lower than that for stage I and II (P = 0.008 and 0.035, respectively). When predicting 2-year PFS based on staging, the AUC of [Ga]Pentixafor PET/CT was significantly higher than that of [Ga]Pentixafor PET (0.923 vs. 0.821, P = 0.002), [F]FDG PET (0.923 vs. 0.752 P = 0.002), and R-ISS (0.923 vs. 0.776, P = 0.005).
[Ga]Pentixafor PET/CT-based staging possesses substantial potential to predict disease progression in newly diagnosed MM patients.
评估[镓]喷替沙福正电子发射断层扫描/计算机断层扫描（[Ga]Pentixafor PET/CT）在新诊断的多发性骨髓瘤（MM）患者基线分期中的预后评估性能，并将其与[氟]脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（[F]FDG PET/CT）以及修订的国际分期系统（R-ISS）进行比较。
回顾性纳入接受[Ga]Pentixafor和[F]FDG PET/CT成像的患者。根据基于[Ga]Pentixafor PET/CT和[F]FDG PET/CT图像的Durie-Salmon PLUS分期系统以及R-ISS对患者进行分期。使用Kaplan-Meier估计器估计患者随访时的无进展生存期（PFS），并使用对数秩检验进行比较。计算受试者操作特征曲线（AUC）下的面积以评估预测性能。
对55例MM患者进行了评估。与[F]FDG PET相比，[Ga]Pentixafor PET将25例患者检测为相同分期，26例患者分期上调，4例患者分期下调（P = 0.001）。在考虑低剂量CT数据后，使用[Ga]Pentixafor PET/CT和[F]FDG PET/CT在每个分期分类的患者数量上没有统计学显著差异（P = 0.091）。基于[Ga]Pentixafor PET/CT的分期区分了不同疾病分期患者的PFS结果（I期与II期、I期与III期、II期与III期；所有P < 0.05），而对于[F]FDG PET/CT，仅I期和III期之间的中位PFS存在差异（P = 0.021）。当按R-ISS分期时，III期的中位PFS显著低于I期和II期（分别为P = 0.008和0.035）。在基于分期预测2年PFS时，[Ga]Pentixafor PET/CT的AUC显著高于[Ga]Pentixafor PET（0.923对0.821，P = 0.002）、[F]FDG PET（0.923对0.752，P = 0.002）和R-ISS（0.923对0.776，P = 0.005）。
基于[Ga]Pentixafor PET/CT的分期在预测新诊断的MM患者疾病进展方面具有巨大潜力。
