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18F-FDG PET/CT in multiple myeloma: critical insights and future directions

  • Clément Bailly
  • Thomas Carlier
  • Bastien Jamet
  • Cyrille Touzeau
  • Philippe Moreau
  • Françoise Kraeber-Bodéré
  • Caroline Bodet-MilinEmail author
Letter to the Editor

Sir,

We read with interest the articles by Jung et al. [1] and Ripani et al. [2] recently published in this journal. These studies point out the prognostic impact of 18F-FDG PET/CT at diagnosis and for therapy assessment in patients with multiple myeloma (MM). They are also the most recent in a wave of published articles which particularly highlight the increased attention received by this imaging technique in this pathology over the last decade. However, we believe it necessary to draw the attention of readers who might be swept along by this prevailing view to the urgent need for standardization to enable the field to move forward. Consistent with previous experience in lymphomas, ensuring reproducibility by establishing clear guidelines [3] is warranted before 18F-FDG PET/CT can be used in everyday routine in MM patients, and such guidelines need to be fully endorsed by the haematology community. The main risk with this flow of publications is that we are drowned in the multitude...

Notes

Acknowledgments

This work was supported in part by grants from the French National Agency for Research (Investissements d’Avenir; IRON Labex grant no. ANR-11-LABX-0018-01, and ArronaxPlus Equipex grant no. ANR-11-EQPX-0004), and from the Institut National du Cancer (grant no. INCa-DGOS-Inserm_12558, SIRIC ILIAD).

Compliance with ethical standards

Conflicts of interest

None.

Ethical approval

This article does not describe any studies with human participants performed by any of the authors.

References

  1. 1.
    Jung S-H, Kwon SY, Min J-J, Bom H-S, Ahn S-Y, Jung S-Y, et al. 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. 2019;46:107–15.CrossRefGoogle Scholar
  2. 2.
    Ripani D, Caldarella C, Za T, Pizzuto DA, Rossi E, De Stefano V, et al. 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. 2019;46:116–28.CrossRefGoogle Scholar
  3. 3.
    Barrington SF, Mikhaeel NG, Kostakoglu L, Meignan M, Hutchings M, Müeller SP, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol. 2014;32:3048–58.CrossRefGoogle Scholar
  4. 4.
    Cavo M, Terpos E, Nanni C, Moreau P, Lentzsch S, Zweegman S, et al. Role of (18)F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group. Lancet Oncol. 2017;18:e206–17.CrossRefGoogle Scholar
  5. 5.
    Bailly C, Leforestier R, Jamet B, Carlier T, Bourgeois M, Guérard F, et al. PET imaging for initial staging and therapy assessment in multiple myeloma patients. Int J Mol Sci. 2017;18:445.CrossRefGoogle Scholar
  6. 6.
    Bartel TB, Haessler J, Brown TLY, Shaughnessy JD, van Rhee F, Anaissie E, et al. F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood. 2009;114:2068–76.CrossRefGoogle Scholar
  7. 7.
    Zamagni E, Patriarca F, Nanni C, Zannetti B, Englaro E, Pezzi A, et al. Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation. Blood. 2011;118:5989–95.CrossRefGoogle Scholar
  8. 8.
    Moreau P, Attal M, Caillot D, Macro M, Karlin L, Garderet L, et al. Prospective evaluation of magnetic resonance imaging and [(18)F]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. 2017;35:2911–8.  https://doi.org/10.1200/JCO.2017.72.2975.CrossRefGoogle Scholar
  9. 9.
    Stolzenburg A, Lückerath K, Samnick S, Speer M, Kneer K, Schmid J-S, et al. Prognostic value of [18F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation. Eur J Nucl Med Mol Imaging. 2018;45:1694–704.CrossRefGoogle Scholar
  10. 10.
    Aljama MA, Sidiqi MH, Buadi FK, Lacy MQ, Gertz MA, Dispenzieri A, et al. Utility and prognostic value of 18F-FDG positron emission tomography-computed tomography scans in patients with newly diagnosed multiple myeloma. Am J Hematol. 2018;93:1518–23.CrossRefGoogle Scholar
  11. 11.
    Rasche L, Chavan SS, Stephens OW, Patel PH, Tytarenko R, Ashby C, et al. Spatial genomic heterogeneity in multiple myeloma revealed by multi-region sequencing. Nat Commun. 2017;8:268.CrossRefGoogle Scholar
  12. 12.
    Weinstock M, Ghobrial IM. Extramedullary multiple myeloma. Leuk Lymphoma. 2013;54:1135–41.CrossRefGoogle Scholar
  13. 13.
    Touzeau C, Moreau P. How I treat extramedullary myeloma. Blood. 2016;127:971–6.CrossRefGoogle Scholar
  14. 14.
    Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, et al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17:e328–46.CrossRefGoogle Scholar
  15. 15.
    Nanni C, Zamagni E, Celli M, Caroli P, Ambrosini V, Tacchetti P, et al. The value of 18F-FDG PET/CT after autologous stem cell transplantation (ASCT) in patients affected by multiple myeloma (MM): experience with 77 patients. Clin Nucl Med. 2013;38:e74–9.CrossRefGoogle Scholar
  16. 16.
    Zamagni E, Nanni C, Mancuso K, Tacchetti P, Pezzi A, Pantani L, et al. PET/CT improves the definition of complete response and allows to detect otherwise unidentifiable skeletal progression in multiple myeloma. Clin Cancer Res. 2015;21:4384–90.CrossRefGoogle Scholar
  17. 17.
    Dimopoulos MA, Hillengass J, Usmani S, Zamagni E, Lentzsch S, Davies FE, et al. Role of magnetic resonance imaging in the management of patients with multiple myeloma: a consensus statement. J Clin Oncol. 2015;33:657–64.CrossRefGoogle Scholar
  18. 18.
    Nanni C, Zamagni E, Versari A, Chauvie S, Bianchi A, Rensi M, et al. Image interpretation criteria for FDG PET/CT in multiple myeloma: a new proposal from an Italian expert panel. IMPeTUs (Italian myeloma criteria for PET USe). Eur J Nucl Med Mol Imaging. 2016;43:414–21.CrossRefGoogle Scholar
  19. 19.
    Nanni C, Versari A, Chauvie S, Bertone E, Bianchi A, Rensi M, et al. Interpretation criteria for FDG PET/CT in multiple myeloma (IMPeTUs): final results. IMPeTUs (Italian myeloma criteria for PET USe). Eur J Nucl Med Mol Imaging. 2018;45:712–9.CrossRefGoogle Scholar
  20. 20.
    Carlier T, Bailly C. State-of-the-art and recent advances in quantification for therapeutic follow-up in oncology using PET. Front Med (Lausanne). 2015;2:18.Google Scholar
  21. 21.
    Bailly C, Carlier T, Jamet B, Eugene T, Touzeau C, Attal M, et al. Interim PET analysis in first-line therapy of multiple myeloma: prognostic value of ΔSUVmax in the FDG-avid patients of the IMAJEM study. Clin Cancer Res. 2018;24:5219–24.CrossRefGoogle Scholar
  22. 22.
    Weber WA, Ziegler SI, Thödtmann R, Hanauske AR, Schwaiger M. Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med. 1999;40:1771–7.Google Scholar
  23. 23.
    Nanni C, Cottereau AS, Lopci E, Bodet-Milin C, Coronado M, Pro B, et al. Report of the 6th International Workshop on PET in lymphoma. Leuk Lymphoma. 2017;58:2298–303.CrossRefGoogle Scholar
  24. 24.
    Zamagni E, Nanni C, Dozza L, Carlier T, Tacchetti P, Versari A, et al. Standardization of 18F-FDG PET/CT according to Deauville criteria for MRD evaluation in newly diagnosed transplant eligible multiple myeloma patients: joined analysis of two prospective randomized phase III trials. Blood. 2018;132:257.Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Clément Bailly
    • 1
    • 2
  • Thomas Carlier
    • 1
    • 2
  • Bastien Jamet
    • 2
  • Cyrille Touzeau
    • 1
    • 3
  • Philippe Moreau
    • 1
    • 3
  • Françoise Kraeber-Bodéré
    • 1
    • 2
    • 4
  • Caroline Bodet-Milin
    • 1
    • 2
    Email author
  1. 1.CRCINA, INSERM, CNRS, Université d’Angers, Université de NantesNantesFrance
  2. 2.Department of Nuclear MedicineCHU de NantesNantesFrance
  3. 3.Department of HematologyCHU de NantesNantesFrance
  4. 4.Department of Nuclear MedicineICO-René GauducheauSaint-HerblainFrance

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