Skip to main content
Erschienen in: European Radiology 1/2021

18.08.2020 | Nuclear Medicine

Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in newly diagnosed multiple myeloma: a systematic review and meta-analysis

verfasst von: Sangwon Han, Sungmin Woo, Yong-il Kim, Dok Hyun Yoon, Jin-Sook Ryu

Erschienen in: European Radiology | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Objectives

We performed a systematic review and meta-analysis on the prognostic values of 18F-FDG PET/CT in patients with newly diagnosed multiple myeloma (MM).

Methods

PubMed and Embase were searched until July 10, 2019, for studies that reported the prognostic significance of 18F-FDG PET in patients with newly diagnosed MM, with overall (OS) and progression-free survival (PFS) included as outcomes. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were meta-analytically pooled using a random-effects model.

Results

Fifteen studies (1670 patients) were included for qualitative synthesis. Among multiple PET parameters, the presence of extramedullary disease (EMD), more than three focal lesions (FLs), and high FDG uptake were widely evaluated and significantly associated with shorter OS and PFS in most of the included studies. Among 11 studies included in quantitative synthesis, the overall HRs of EMD, more than three FLs, and high FDG uptake on PFS were 2.12 (95% CI, 1.52–2.96), 2.38 (95% CI, 1.84–3.07), and 2.02 (95% CI, 1.51–2.68), respectively. The pooled HRs of those three parameters on OS were 2.37 (95% CI, 1.77–3.16), 3.29 (95% CI, 2.38–4.56), and 2.28 (95% CI, 1.67–3.13). No statistical differences were found across parameters for either PFS (p = 0.6822) or OS (p = 0.2147).

Conclusions

Pretreatment 18F-FDG PET/CT is a significant predictor for disease progression and survival in patients with MM. It may be a useful prognostic biomarker capable of accurate risk stratification and application in clinical decision-making for newly diagnosed MM.

Key Points

• There remain unmet clinical needs for reliable prognostic biomarkers in patients with newly diagnosed multiple myeloma.
• This meta-analysis shows that the presence of extramedullary disease, more than three focal lesions, and high FDG uptake from baseline 18 F-FDG PET are significant prognostic factors.
• These imaging biomarkers might help the accurate stratification of patient prognosis which is required for choosing an appropriate therapeutic strategy in clinical practice.
Literatur
1.
Zurück zum Zitat Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69:7–34PubMed Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69:7–34PubMed
2.
Zurück zum Zitat Hillengass J, Usmani S, Rajkumar SV et al (2019) International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders. Lancet Oncol 20:e302–e312PubMed Hillengass J, Usmani S, Rajkumar SV et al (2019) International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders. Lancet Oncol 20:e302–e312PubMed
3.
Zurück zum Zitat Kumar SK, Callander NS, Biermann JS et al (2019) Multiple myeloma, version 3.2019, NCCN clinical practice guidelines in oncology. Kumar SK, Callander NS, Biermann JS et al (2019) Multiple myeloma, version 3.2019, NCCN clinical practice guidelines in oncology.
4.
Zurück zum Zitat Moreau P, San Miguel J, Sonneveld P et al (2017) Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 28:iv52–iv61PubMed Moreau P, San Miguel J, Sonneveld P et al (2017) Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 28:iv52–iv61PubMed
5.
Zurück zum Zitat Chantry A, Kazmi M, Barrington S et al (2017) Guidelines for the use of imaging in the management of patients with myeloma. Br J Haematol 178:380–393PubMed Chantry A, Kazmi M, Barrington S et al (2017) Guidelines for the use of imaging in the management of patients with myeloma. Br J Haematol 178:380–393PubMed
6.
Zurück zum Zitat Hari PN, Zhang MJ, Roy V et al (2009) Is the International Staging System superior to the Durie-Salmon staging system? A comparison in multiple myeloma patients undergoing autologous transplant. Leukemia 23:1528–1534PubMedPubMedCentral Hari PN, Zhang MJ, Roy V et al (2009) Is the International Staging System superior to the Durie-Salmon staging system? A comparison in multiple myeloma patients undergoing autologous transplant. Leukemia 23:1528–1534PubMedPubMedCentral
7.
Zurück zum Zitat Greipp PR, San Miguel J, Durie BG et al (2005) International staging system for multiple myeloma. J Clin Oncol 23:3412–3420PubMed Greipp PR, San Miguel J, Durie BG et al (2005) International staging system for multiple myeloma. J Clin Oncol 23:3412–3420PubMed
8.
Zurück zum Zitat Palumbo A, Avet-Loiseau H, Oliva S et al (2015) Revised International Staging System for Multiple Myeloma: a report from International Myeloma Working Group. J Clin Oncol 33:2863–2869PubMedPubMedCentral Palumbo A, Avet-Loiseau H, Oliva S et al (2015) Revised International Staging System for Multiple Myeloma: a report from International Myeloma Working Group. J Clin Oncol 33:2863–2869PubMedPubMedCentral
9.
Zurück zum Zitat Bataille R, Annweiler C, Beauchet O (2013) Multiple myeloma international staging system: “staging” or simply “aging” system? Clin Lymphoma Myeloma Leuk 13:635–637PubMed Bataille R, Annweiler C, Beauchet O (2013) Multiple myeloma international staging system: “staging” or simply “aging” system? Clin Lymphoma Myeloma Leuk 13:635–637PubMed
10.
Zurück zum Zitat Erez A, Shental O, Tchebiner JZ et al (2014) Diagnostic and prognostic value of very high serum lactate dehydrogenase in admitted medical patients. Isr Med Assoc J 16:439–443PubMed Erez A, Shental O, Tchebiner JZ et al (2014) Diagnostic and prognostic value of very high serum lactate dehydrogenase in admitted medical patients. Isr Med Assoc J 16:439–443PubMed
11.
Zurück zum Zitat Abe Y, Narita K, Kobayashi H et al (2019) Pretreatment 18F-FDG PET/CT combined with quantification of clonal circulating plasma cells as a potential risk model in patients with newly diagnosed multiple myeloma. Eur J Nucl Med Mol Imaging 46:1325–1333PubMed Abe Y, Narita K, Kobayashi H et al (2019) Pretreatment 18F-FDG PET/CT combined with quantification of clonal circulating plasma cells as a potential risk model in patients with newly diagnosed multiple myeloma. Eur J Nucl Med Mol Imaging 46:1325–1333PubMed
12.
Zurück zum Zitat Aljama MA, Sidiqi MH, Buadi FK et al (2018) Utility and prognostic value of 18F-FDG positron emission tomography-computed tomography scans in patients with newly diagnosed multiple myeloma. Am J Hematol 93:1518–1523PubMed Aljama MA, Sidiqi MH, Buadi FK et al (2018) Utility and prognostic value of 18F-FDG positron emission tomography-computed tomography scans in patients with newly diagnosed multiple myeloma. Am J Hematol 93:1518–1523PubMed
13.
Zurück zum Zitat Bartel TB, Haessler J, Brown TL et al (2009) F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood 114:2068–2076PubMedPubMedCentral Bartel TB, Haessler J, Brown TL et al (2009) F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood 114:2068–2076PubMedPubMedCentral
14.
Zurück zum Zitat Batsukh K, Lee SE, Min GJ et al (2017) Distinct clinical outcomes between paramedullary and extramedullary lesions in newly diagnosed multiple myeloma. Immune Netw 17:250–260PubMedPubMedCentral Batsukh K, Lee SE, Min GJ et al (2017) Distinct clinical outcomes between paramedullary and extramedullary lesions in newly diagnosed multiple myeloma. Immune Netw 17:250–260PubMedPubMedCentral
15.
Zurück zum Zitat Deng S, Zhang B, Zhou Y et al (2018) The role of 18F-FDG PET/CT in multiple myeloma staging according to IMPeTUs: comparison of the Durie-Salmon plus and other staging systems. Contrast Media Mol Imaging 2018:4198673PubMedPubMedCentral Deng S, Zhang B, Zhou Y et al (2018) The role of 18F-FDG PET/CT in multiple myeloma staging according to IMPeTUs: comparison of the Durie-Salmon plus and other staging systems. Contrast Media Mol Imaging 2018:4198673PubMedPubMedCentral
16.
Zurück zum Zitat Dimitrakopoulou-Strauss A, Hoffmann M, Bergner R, Uppenkamp M, Haberkorn U, Strauss LG (2009) Prediction of progression-free survival in patients with multiple myeloma following anthracycline-based chemotherapy based on dynamic FDG-PET. Clin Nucl Med 34:576–584PubMed Dimitrakopoulou-Strauss A, Hoffmann M, Bergner R, Uppenkamp M, Haberkorn U, Strauss LG (2009) Prediction of progression-free survival in patients with multiple myeloma following anthracycline-based chemotherapy based on dynamic FDG-PET. Clin Nucl Med 34:576–584PubMed
17.
Zurück zum Zitat Fonti R, Pace L, Cerchione C et al (2015) 18F-FDG PET/CT, 99mTc-MIBI, and MRI in the prediction of outcome of patients with multiple myeloma: a comparative study. Clin Nucl Med 40:303–308PubMed Fonti R, Pace L, Cerchione C et al (2015) 18F-FDG PET/CT, 99mTc-MIBI, and MRI in the prediction of outcome of patients with multiple myeloma: a comparative study. Clin Nucl Med 40:303–308PubMed
18.
Zurück zum Zitat Haznedar R, Aki SZ, Akdemir OU et al (2011) Value of 18F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma. Eur J Nucl Med Mol Imaging 38:1046–1053PubMed Haznedar R, Aki SZ, Akdemir OU et al (2011) Value of 18F-fluorodeoxyglucose uptake in positron emission tomography/computed tomography in predicting survival in multiple myeloma. Eur J Nucl Med Mol Imaging 38:1046–1053PubMed
19.
Zurück zum Zitat Jung SH, Kwon SY, Min JJ et al (2019) 18F-FDG PET/CT is useful for determining survival outcomes of patients with multiple myeloma classified as stage II and III with the Revised International Staging System. Eur J Nucl Med Mol Imaging 46:107–115PubMed Jung SH, Kwon SY, Min JJ et al (2019) 18F-FDG PET/CT is useful for determining survival outcomes of patients with multiple myeloma classified as stage II and III with the Revised International Staging System. Eur J Nucl Med Mol Imaging 46:107–115PubMed
20.
Zurück zum Zitat Li Q, Ma J, Li H et al (2019) Correlation Between Uptake of 18F-FDG During PET/CT and Ki-67 Expression in Patients Newly Diagnosed With Multiple Myeloma Having Extramedullary Involvement. Technol Cancer Res Treat 18:1533033819849067PubMedPubMedCentral Li Q, Ma J, Li H et al (2019) Correlation Between Uptake of 18F-FDG During PET/CT and Ki-67 Expression in Patients Newly Diagnosed With Multiple Myeloma Having Extramedullary Involvement. Technol Cancer Res Treat 18:1533033819849067PubMedPubMedCentral
21.
Zurück zum Zitat Moon SH, Choi WH, Yoo IR et al (2018) Prognostic Value of Baseline 18F-Fluorodeoxyglucose PET/CT in patients with multiple myeloma: a multicenter cohort study. Korean J Radiol 19:481–488PubMedPubMedCentral Moon SH, Choi WH, Yoo IR et al (2018) Prognostic Value of Baseline 18F-Fluorodeoxyglucose PET/CT in patients with multiple myeloma: a multicenter cohort study. Korean J Radiol 19:481–488PubMedPubMedCentral
22.
Zurück zum Zitat Moreau P, Attal M, Caillot D et al (2017) Prospective evaluation of magnetic resonance imaging and [18F]fluorodeoxyglucose positron emission tomography-computed Tomography at diagnosis and before maintenance therapy in symptomatic patients with multiple myeloma included in the IFM/DFCI 2009 trial: results of the IMAJEM study. J Clin Oncol 35:2911–2918PubMedPubMedCentral Moreau P, Attal M, Caillot D et al (2017) Prospective evaluation of magnetic resonance imaging and [18F]fluorodeoxyglucose positron emission tomography-computed Tomography at diagnosis and before maintenance therapy in symptomatic patients with multiple myeloma included in the IFM/DFCI 2009 trial: results of the IMAJEM study. J Clin Oncol 35:2911–2918PubMedPubMedCentral
23.
Zurück zum Zitat Sachpekidis C, Merz M, Kopp-Schneider A et al (2019) Quantitative dynamic 18F-FDG PET/CT before autologous stem cell transplantation predicts survival in multiple myeloma. Haematologica 104:e420–e423PubMedPubMedCentral Sachpekidis C, Merz M, Kopp-Schneider A et al (2019) Quantitative dynamic 18F-FDG PET/CT before autologous stem cell transplantation predicts survival in multiple myeloma. Haematologica 104:e420–e423PubMedPubMedCentral
24.
Zurück zum Zitat Tu H, He Y, Huang T et al (2018) Predictive value of 18F-FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma. Eur J Haematol 100:189–197PubMed Tu H, He Y, Huang T et al (2018) Predictive value of 18F-FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma. Eur J Haematol 100:189–197PubMed
25.
Zurück zum Zitat Zamagni E, Patriarca F, Nanni C et al (2011) Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation. Blood 118:5989–5995PubMed Zamagni E, Patriarca F, Nanni C et al (2011) Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation. Blood 118:5989–5995PubMed
26.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097PubMedPubMedCentral Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097PubMedPubMedCentral
27.
Zurück zum Zitat Hayden JA, van der Windt DA, Cartwright JL, Cote P, Bombardier C (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158:280–286PubMed Hayden JA, van der Windt DA, Cartwright JL, Cote P, Bombardier C (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158:280–286PubMed
28.
Zurück zum Zitat Guyot P, Ades AE, Ouwens MJ, Welton NJ (2012) Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves. BMC Med Res Methodol 12:9PubMedPubMedCentral Guyot P, Ades AE, Ouwens MJ, Welton NJ (2012) Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves. BMC Med Res Methodol 12:9PubMedPubMedCentral
29.
30.
Zurück zum Zitat Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedPubMedCentral Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedPubMedCentral
31.
Zurück zum Zitat Duval S, Tweedie R (2000) Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56:455–463PubMed Duval S, Tweedie R (2000) Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56:455–463PubMed
32.
Zurück zum Zitat Durie BG, Salmon SE (1975) A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer 36:842–854PubMed Durie BG, Salmon SE (1975) A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer 36:842–854PubMed
33.
Zurück zum Zitat Varettoni M, Corso A, Pica G, Mangiacavalli S, Pascutto C, Lazzarino M (2010) Incidence, presenting features and outcome of extramedullary disease in multiple myeloma: a longitudinal study on 1003 consecutive patients. Ann Oncol 21:325–330PubMed Varettoni M, Corso A, Pica G, Mangiacavalli S, Pascutto C, Lazzarino M (2010) Incidence, presenting features and outcome of extramedullary disease in multiple myeloma: a longitudinal study on 1003 consecutive patients. Ann Oncol 21:325–330PubMed
34.
Zurück zum Zitat Lecouvet FE, Boyadzhiev D, Collette L et al (2020) MRI versus (18)F-FDG-PET/CT for detecting bone marrow involvement in multiple myeloma: diagnostic performance and clinical relevance. Eur Radiol 30:1927–1937PubMed Lecouvet FE, Boyadzhiev D, Collette L et al (2020) MRI versus (18)F-FDG-PET/CT for detecting bone marrow involvement in multiple myeloma: diagnostic performance and clinical relevance. Eur Radiol 30:1927–1937PubMed
35.
Zurück zum Zitat Soret M, Bacharach SL, Buvat I (2007) Partial-volume effect in PET tumor imaging. J Nucl Med 48:932–945PubMed Soret M, Bacharach SL, Buvat I (2007) Partial-volume effect in PET tumor imaging. J Nucl Med 48:932–945PubMed
36.
Zurück zum Zitat Lee HS, Oh JS, Park YS, Jang SJ, Choi IS, Ryu JS (2016) Differentiating the grades of thymic epithelial tumor malignancy using textural features of intratumoral heterogeneity via (18)F-FDG PET/CT. Ann Nucl Med 30:309–319PubMed Lee HS, Oh JS, Park YS, Jang SJ, Choi IS, Ryu JS (2016) Differentiating the grades of thymic epithelial tumor malignancy using textural features of intratumoral heterogeneity via (18)F-FDG PET/CT. Ann Nucl Med 30:309–319PubMed
37.
Zurück zum Zitat Oh M, Seo M, Oh SY et al (2018) Clinical significance of visually equivocal amyloid PET findings from the Alzheimer’s Disease Neuroimaging Initiative cohort. Neuroreport 29:553–558PubMed Oh M, Seo M, Oh SY et al (2018) Clinical significance of visually equivocal amyloid PET findings from the Alzheimer’s Disease Neuroimaging Initiative cohort. Neuroreport 29:553–558PubMed
38.
Zurück zum Zitat Lasnon C, Desmonts C, Quak E et al (2013) Harmonizing SUVs in multicentre trials when using different generation PET systems: prospective validation in non-small cell lung cancer patients. Eur J Nucl Med Mol Imaging 40:985–996PubMedPubMedCentral Lasnon C, Desmonts C, Quak E et al (2013) Harmonizing SUVs in multicentre trials when using different generation PET systems: prospective validation in non-small cell lung cancer patients. Eur J Nucl Med Mol Imaging 40:985–996PubMedPubMedCentral
39.
Zurück zum Zitat Wahl RL, Jacene H, Kasamon Y, Lodge MA (2009) From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med 50(Suppl 1):122 s–150 s Wahl RL, Jacene H, Kasamon Y, Lodge MA (2009) From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med 50(Suppl 1):122 s–150 s
40.
Zurück zum Zitat Ripani D, Caldarella C, Za T et al (2019) Prognostic significance of normalized FDG-PET parameters in patients with multiple myeloma undergoing induction chemotherapy and autologous hematopoietic stem cell transplantation: a retrospective single-center evaluation. Eur J Nucl Med Mol Imaging 46:116–128PubMed Ripani D, Caldarella C, Za T et al (2019) Prognostic significance of normalized FDG-PET parameters in patients with multiple myeloma undergoing induction chemotherapy and autologous hematopoietic stem cell transplantation: a retrospective single-center evaluation. Eur J Nucl Med Mol Imaging 46:116–128PubMed
41.
Zurück zum Zitat Fonti R, Larobina M, Del Vecchio S et al (2012) Metabolic tumor volume assessed by 18F-FDG PET/CT for the prediction of outcome in patients with multiple myeloma. J Nucl Med 53:1829–1835PubMed Fonti R, Larobina M, Del Vecchio S et al (2012) Metabolic tumor volume assessed by 18F-FDG PET/CT for the prediction of outcome in patients with multiple myeloma. J Nucl Med 53:1829–1835PubMed
42.
Zurück zum Zitat McDonald JE, Kessler MM, Gardner MW et al (2017) Assessment of total lesion glycolysis by (18)F FDG PET/CT significantly improves prognostic value of GEP and ISS in myeloma. Clin Cancer Res 23:1981–1987PubMed McDonald JE, Kessler MM, Gardner MW et al (2017) Assessment of total lesion glycolysis by (18)F FDG PET/CT significantly improves prognostic value of GEP and ISS in myeloma. Clin Cancer Res 23:1981–1987PubMed
Metadaten
Titel
Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in newly diagnosed multiple myeloma: a systematic review and meta-analysis
verfasst von
Sangwon Han
Sungmin Woo
Yong-il Kim
Dok Hyun Yoon
Jin-Sook Ryu
Publikationsdatum
18.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 1/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07177-x

Weitere Artikel der Ausgabe 1/2021

European Radiology 1/2021 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.