Abstract

Many efforts have been made to standardize the interpretation of 18F-FDG PET/CT in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18F-FDG PET/CT considering the extent and intensity of bone 18F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement - PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00–1.35). Visual analysis categorized PET exams into three groups (negative/mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients’ hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.

Details

Title
Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma
Author
Takahashi, Maria E S 1 ; Mosci, Camila 2 ; Souza, Edna M 3 ; Brunetto, Sérgio Q 3 ; Etchebehere, Elba 2   VIAFID ORCID Logo  ; Santos, Allan O 2 ; Camacho, Mariana R 4 ; Miranda, Eliana 5 ; Lima, Mariana C L 2 ; Amorim, Barbara J 2 ; de Souza, Carmino 6 ; Pericole, Fernando V 5 ; Lorand-Metze, Irene 7 ; Ramos, Celso D 4   VIAFID ORCID Logo 

1  School of Medical Sciences, University of Campinas, Campinas, Brazil; Gleb Wataghin Physics Institute, University of Campinas, Campinas, Brazil 
2  Division of Nuclear Medicine, University of Campinas, Campinas, Brazil 
3  Division of Nuclear Medicine, University of Campinas, Campinas, Brazil; Center of Biomedical Engineering, University of Campinas, Campinas, Brazil 
4  School of Medical Sciences, University of Campinas, Campinas, Brazil; Division of Nuclear Medicine, University of Campinas, Campinas, Brazil 
5  Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil 
6  School of Medical Sciences, University of Campinas, Campinas, Brazil; Center of Hematology and Hemotherapy, University of Campinas, Campinas, Brazil 
7  Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil; School of Medical Sciences, University of Campinas, Campinas, Brazil 
Pages
1-8
Publication year
2019
Publication date
Nov 2019
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-019-52740-2
ProQuest document ID
2313767415
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.