Current and Potential Applications of Positron Emission Tomography for Multiple Myeloma and Plasma Cell Disorders

Publication date: Available online 17 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Gary A. Ulaner, C. Ola LandgrenAbstractFluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) allows evaluation of elevated glucose metabolism in malignancies. There has been increasing interest in FDG PET/CT for plasma cell disorders since the International Myeloma Working Group outlined multiple applications of this imaging modality, including distinguishing smoldering myeloma from active multiple myeloma, confirmation of solitary plasmacytoma, and multiple indications in patients with known multiple myeloma, including determining extent of initial disease, monitoring therapy response, and detection of residual disease following therapy. The field of molecular imaging is now shifting focus from evaluation of metabolism to targeted evaluation of specific tumor markers. Targeted PET imaging targeted of CXCR4 and CD38 has advanced into translational clinical trials, bringing us closer to powerful imaging options for myeloma. In this review we discuss the current applications of FDG PET/CT in plasma cell disorders, as well as advances in targeted PET imaging.
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research

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Conclusion PET/CT resulted in a change in planned management in more than two-thirds of patients with plasma cell disorders in the current selected patient cohort. These results should be validated in a larger prospective trial.
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Purpose PET/CT with both 11C-choline and 11C-methionine has recently been reported to offer advantages over 18F-FDG for imaging in multiple myeloma (MM). The aim of this study was to directly compare the diagnostic performance of both non-FDG radiotracers in MM patients. Methods Nineteen patients with a history of MM (n = 18) or solitary bone plasmacytoma (n = 1) underwent both 11C-choline and 11C-methionine PET/CT for diagnostic imaging. In this retrospective analysis, scans were compared on a patient and on a lesion basis. In 12 patients, respective tracer uptake in the iliac crest was correlated with the extent of ...
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Original Articles Source Type: research
mopoulos MA Abstract Here, we are reporting the outcome of 226 myeloma patients presenting with extramedullary plasmacytoma or paraosseous involvement in a retrospective study conducted in 19 centers from 11 countries. Extramedullary disease was detected at diagnosis or relapse between January 2010 and November 2017. Extramedullary plasmacytoma and paraosseous involvement were observed in 130 patients at diagnosis (92/38) and in 96 at relapse (84/12). The median time from multiple myeloma diagnosis to the development of extramedullary disease was 25.1 months (range 3.1-106.3 months) in the relapse group (median fo...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
19Aim: Positron emission tomography/computed tomography (PET/CT) with both 11C-choline and 11C-methionine has recently been reported to offer advantages over 18F-2`-deoxy-2`-fluorodeoxyglucose (FDG) for staging and re-staging in multiple myeloma (MM). The aim of this study was to directly compare the diagnostic performance of both non-FDG radiotracers in MM patients. Methods: Nineteen patients with a history of MM (n=18) or solitary bone plasmacytoma (n=1) underwent both 11C-choline- and 11C-methionine-PET/CT for diagnostic imaging within 10 days (median, 1 day). Scans were compared on a patient and on a lesion basis inclu...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Multiple Myeloma Source Type: research
ConclusionsMultiple myeloma has myriad presentations. Gastrointestinal involvement, although rare, can manifest as small bowel obstruction for which early recognition and appropriate surgical management are key to improving outcome. Intussusception is the most common mechanism of obstruction from extramedullary plasmacytoma causing small bowel obstruction and this has been seen in five of six case reports, including this case. It is important to recognize and consider the risks of immunosuppression, venous thromboembolism, and malnutrition in the surgical management of gastrointestinal complications of multiple myeloma.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Rationale: The incidence of extramedullary plasmacytoma (EMP) accounts for 3% to 4% of all cases of generalized plasmacytoma. The most common pathogenic sites are the head and the neck. It is noteworthy that the pathogenic site in this case is extraperitoneal, which is uncommon in clinical practice. In this case report, we aim to discuss the clinical features and diagnosis as well as the treatment methods of EMP. Patient concerns: A 30-year-old female was admitted to our hospital due to a palpable right upper abdominal mass without symptoms of abdominal pain, diarrhea, constipation, fever, or oliguria. Diagnosis and ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We report a case of a patient who developed an extramedullary plasmacytoma-like PTLD around his transplanted kidney treated with standard multiple myeloma chemotherapy. Three years after benefiting of a deceased donor kidney transplant for an end stage kidney disease secondary to nephroangiosclerosis, our patient developed an extra-medullary plasmacytoma confined to the transplant compartment. The transplant function was unaltered, and due to the absence of reduction of the lesion after immunosuppression reduction, a chemotherapy by bortezomib-cyclophosphamide-dexamethasone (VCD) known to be efficient in multiple myeloma w...
Source: Nephrologie and Therapeutique - Category: Urology & Nephrology Authors: Tags: Nephrol Ther Source Type: research
ConclusionsThis case illustrates the protean initial manifestations of multiple myeloma and the importance of an accurate diagnosis. Our patient ’s initial presentation with gastrointestinal complaints is rare and the plasmacytoma location is even rarer, providing a challenging diagnostic problem. Prompt recognition of multiple myeloma is critical to institute appropriate therapy and prevention of disease progression.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
11C-methionine (MET) has recently emerged as an accurate marker of tumor burden and disease activity in patients with multiple myeloma (MM). This dual-center study aimed at further corroboration of the superiority of MET as positron emission tomography (PET) tracer for staging and re-staging MM, as compared to 18F-2`-deoxy-2`-fluoro-D-glucose (FDG).78 patients with a history of solitary plasmacytoma (n=4), smoldering MM (SMM, n=5), and symptomatic MM (n=69) underwent both MET- and FDG-PET/computed tomography (CT) at the University Centers of Würzburg, Germany and Navarra, Spain. Scans were compared on a patient and on...
Source: Theranostics - Category: Molecular Biology Authors: Tags: Research Paper Source Type: research
is a rare disease characterized by a localized proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. It can be subdivided into solitary bone plasmacytoma, if the lesion originates in bone, or solitary extramedullary plasmacytoma, if the lesion involves a soft tissue. Incidence of solitary bone plasmacytoma is higher than solitary extramedullary plasmacytoma. Also prognosis is different: even if both forms respond well to treatment, overall survival and progression free survival of solitary bone plasmacytoma is poorer than solitary extramedullary plasmacytoma due to its higher rate of e...
Source: Mediterranean Journal of Hematology and Infectious Diseases - Category: Hematology Source Type: research
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