PET/CT in Multiple Myeloma: Imaging Insights Using 18F-FDG for Staging & Prognosis

Multiple myeloma (MM) is the second most common blood cancer after non-Hodgkin lymphoma. Modern diagnosis and treatment planning rely heavily on 18F-FDG PET/CT, which merges functional and anatomical imaging. This allows for:

• • Accurate diagnosis and initial staging
  • Prognostic assessment through metabolic indicators
  • Ongoing treatment monitoring and progression tracking

A study published in the Egyptian Journal of Radiology and Nuclear Medicine highlights how semiquantitative PET/CT parameters offer a more refined view of MM staging and metabolic tumor burden.

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In this retrospective study, 50 patients with suspected MM underwent whole-body 18F-FDG PET/CT. Researchers examined:

• Number of focal lesions (FLs)
• SUVmax of the most metabolically active lesion
• Marrow-to-spleen SUVmean and SULpeak ratios
• Total metabolic tumor volume (MTV)

Results showed strong correlations between high metabolic activity and advanced disease states, reinforcing PET/CT’s predictive value in MM.

Key demographics and findings:

• • 39 patients were confirmed MM cases
  • 59% were male with an average age of 65
  • Patients divided by lesion count:
  • Group A: >10 lesions
  • Group B: 5–10 lesions
  • Group C: <5 lesions

Patients with higher lesion counts and SUV values tended to experience more aggressive disease. These semiquantitative measures give oncologists valuable insights for early intervention and treatment personalization.

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Highlights from the study:

• Patients with higher metabolic uptake showed faster progression
• PET/CT metrics correlated with poor treatment response
• May guide timing for autologous stem cell transplantation (ASCT)
• Offers repeatable imaging metrics to monitor treatment impact

This suggests PET/CT can support individualized treatment strategies, helping providers determine whether to escalate or adjust therapies early on.

Sources:
De Feo, M.S., Filippi, L., Frantellizzi, V. et al. – Multiple Myeloma: Characterization of Patients Using 18F-FDG PET/CT. Egyptian Journal of Radiology and Nuclear Medicine.

Media Contact:
Blake Kenney
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Shared Medical Services, Inc.
Phone: (608) 910-1332
Email: contactsms@sharedmed.com