Potential of PET/CT with 18F-FDG in Assessmentof the Status of Disease in Patients with Multiple Myeloma
The article presents the first results of the study of the potential opportunities of positron emission tomography combined with computed tomography with fluorodeoxyglucose (PET/CT with 18F-FDG) in assessing the status of the disease in patients with multiple myeloma (MM).There was made the analysis of 99 PET/CT with 18F-FDG in 15 patients with confirmed diagnosis of MM. The results were differentiated into the following four groups, according to the determined disease status at the time of the study: 1 - strict complete remission and complete remission (sCR; CR); 2 - very good partial remission and partial remission (VGPR; PR); 3 - stabilization of the disease (SD); 4 - progressive disease (PD).After each study, the maximum accumulation level of the radiopharmaceutical drug or the radiotracer (Standard uptake value - SUVmax) was measured and compared; in our study, 18F-FDG was used as the radiotracer.When comparing the medians of the level of accumulation of 18F-FDG in the group 1, lower SUVmax values were observed, if compared to other groups. In the group 4, the increased values of SUVmax were observed, if compared to other groups.Having made a pairwise comparison of the SUVmax medians in the control groups, statistically significant differences (p>0.01) were found in the groups 1 and 3; 1 and 4; 2 and 4.For possible use of the reference values of liver SUVmax in the assessment of MM remission, the formed groups 1 and 2 were used. In the control groups, the values of liver SUV and SUVmax in pathological foci were measured and compared. When comparing SUVmax in pathological foci and liver, there was the difference in the prevalence of accumulation of 18F-FDG in pathological foci, despite the status of the disease.There were made the conclusions that indicate that in different statuses of disease, the level of SUVmax varies significantly, which lets to speak about the possibility of using this parameter to assess the response to treatment. It was also revealed that the reference values of liver SUV couldn't be used to assess remission in MM.