TY - JOUR
T1 - 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
AU - Ripani, Daria
AU - Caldarella, Carmelo
AU - Za, Tommaso
AU - Pizzuto, Daniele Antonio
AU - Rossi, Elena
AU - De Stefano, Valerio
AU - Giordano, Alessandro
PY - 2019
Y1 - 2019
N2 - Purpose: The purpose of this study was to determine retrospectively, through a single-center evaluation, whether FDG PET-CT normalized semi-quantitative parameters may predict response to induction chemotherapy (iChT) and hematopoietic stem cell transplantation (HSCT), as well as disease progression and progression-free survival in multiple myeloma (MM) patients, thus becoming a tool of personalized medicine. Methods: Patients undergoing iChT and HSCT with baseline and post-treatment FDG PET-CTs from January 2008 to July 2015 were included. The following baseline and post-treatment parameters were obtained: SUVmax, SUVmean, SUVpeak, MTVsum, TLGsum, rPET (lesion SUVmax/liver SUVmax) and qPET (lesion SUVpeak/liver SUVmean). Baseline-to-post-treatment changes (Δ) were also calculated. Metabolic and clinical laboratory progression or response at follow-up were noted; time-to-metabolic-progression (TMP) was defined as the interval from post-treatment scan to eventual progression at follow-up FDG PET-CTs. Possible association between each functional parameter and metabolic/clinical-laboratory progression or response was determined. Kaplan-Meier curves allowed to depict the TMP trend according to FDG PET-CT parameters. Results: Twenty-eight patients were included. Significantly higher ΔrPET and ΔqPET values were observed in ten patients with “metabolic response”, with respect to 18 patients having “metabolic progression” (median 0.62 [IQR 0.32 – 1.34] vs median 0.00 [IQR -0.25 – 0.49] for ΔrPET; P = 0.045; median 0.51 [IQR 0.32 – 1.13] vs median 0.00 [IQR -0.31 – 0.67] for ΔqPET; P = 0.035). Neither normalized nor non normalized parameters differed significantly between the 20 patients with “clinical-laboratory response” and the eight patients with “clinical-laboratory progression”. ΔrPET value lower than 0.38 and ΔqPET value lower than 0.27 predicted a significantly shorter TMP (P = 0.003 and P = 0.005, respectively). Conclusions: Normalized semi-quantitative parameters are effective in predicting persistent response to treatment and shorter TMP in patients with MM undergoing iChT and HSCT.
AB - Purpose: The purpose of this study was to determine retrospectively, through a single-center evaluation, whether FDG PET-CT normalized semi-quantitative parameters may predict response to induction chemotherapy (iChT) and hematopoietic stem cell transplantation (HSCT), as well as disease progression and progression-free survival in multiple myeloma (MM) patients, thus becoming a tool of personalized medicine. Methods: Patients undergoing iChT and HSCT with baseline and post-treatment FDG PET-CTs from January 2008 to July 2015 were included. The following baseline and post-treatment parameters were obtained: SUVmax, SUVmean, SUVpeak, MTVsum, TLGsum, rPET (lesion SUVmax/liver SUVmax) and qPET (lesion SUVpeak/liver SUVmean). Baseline-to-post-treatment changes (Δ) were also calculated. Metabolic and clinical laboratory progression or response at follow-up were noted; time-to-metabolic-progression (TMP) was defined as the interval from post-treatment scan to eventual progression at follow-up FDG PET-CTs. Possible association between each functional parameter and metabolic/clinical-laboratory progression or response was determined. Kaplan-Meier curves allowed to depict the TMP trend according to FDG PET-CT parameters. Results: Twenty-eight patients were included. Significantly higher ΔrPET and ΔqPET values were observed in ten patients with “metabolic response”, with respect to 18 patients having “metabolic progression” (median 0.62 [IQR 0.32 – 1.34] vs median 0.00 [IQR -0.25 – 0.49] for ΔrPET; P = 0.045; median 0.51 [IQR 0.32 – 1.13] vs median 0.00 [IQR -0.31 – 0.67] for ΔqPET; P = 0.035). Neither normalized nor non normalized parameters differed significantly between the 20 patients with “clinical-laboratory response” and the eight patients with “clinical-laboratory progression”. ΔrPET value lower than 0.38 and ΔqPET value lower than 0.27 predicted a significantly shorter TMP (P = 0.003 and P = 0.005, respectively). Conclusions: Normalized semi-quantitative parameters are effective in predicting persistent response to treatment and shorter TMP in patients with MM undergoing iChT and HSCT.
KW - Aged
KW - Female
KW - Fluorodeoxyglucose F18
KW - Hematopoietic Stem Cell Transplantation
KW - Hematopoietic stem cell transplantation
KW - Humans
KW - Induction Chemotherapy
KW - Induction chemotherapy
KW - Male
KW - Middle Aged
KW - Multiple Myeloma
KW - Multiple myeloma
KW - Normalized parameters
KW - Personalized medicine
KW - Positron Emission Tomography Computed Tomography
KW - Predictive Value of Tests
KW - Radiopharmaceuticals
KW - Time-to-metabolic progression
KW - Transplantation, Autologous
KW - Treatment Outcome
KW - Aged
KW - Female
KW - Fluorodeoxyglucose F18
KW - Hematopoietic Stem Cell Transplantation
KW - Hematopoietic stem cell transplantation
KW - Humans
KW - Induction Chemotherapy
KW - Induction chemotherapy
KW - Male
KW - Middle Aged
KW - Multiple Myeloma
KW - Multiple myeloma
KW - Normalized parameters
KW - Personalized medicine
KW - Positron Emission Tomography Computed Tomography
KW - Predictive Value of Tests
KW - Radiopharmaceuticals
KW - Time-to-metabolic progression
KW - Transplantation, Autologous
KW - Treatment Outcome
UR - http://hdl.handle.net/10807/140221
UR - http://link.springer.com/journal/volumesandissues/259
U2 - 10.1007/s00259-018-4108-y
DO - 10.1007/s00259-018-4108-y
M3 - Article
SN - 1619-7070
VL - 46
SP - 116
EP - 128
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
ER -