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J Nucl Med. 2008; 49 (Supplement 1):148P
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Oncology-Clinical Diagnosis: Hematologic Tumors

Clinical Diagnosis: Hematologic Tumors Posters

Comparison of imaging with methionine-PET and FDG-PET in multiple myeloma

Kakuko Kanegae1, Shouzo Okamoto1, Songji Zhao1, Kenji Hirata1, Mitsufumi Nishio1, Akio Shigematsu1, Tokuhiko Omatsu1, Yuji Kuge1 and Nagara Tamaki1

1 Nuclear Medicine, Hokkaido University, Sapporo, Japan

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Objectives: FDG-PET has improved the detection of diseases in patients with multiple myeloma. However, false negative results were reported with FDG-PET. C-11-methionine (MET) is commonly used tumor-seeking PET tracer and has been used to measure amino acid metabolism and protein synthesis. This is a prospective study to assess the value of MET-PET in myeloma and compare with FDG-PET.

Methods: Ten patients received both whole body MET-PET and FDG-PET whithin three days. Of the 10 patients, 7 were relapsed myeloma, 2 were before myeloma therapy, and 1 was after radiation of solitary plasmacytoma. The uptake scores of FDG and MET were visually graded from 0 (no uptake) to 2+ (intense uptake).

Results: Of the 10 patients, 8 had medullary and extramedullary myeloma lesions, 1 had solitary plasmacytoma and 1 had monoclonal gammopathy of undetermined significance (MGUS). In the 8 patients, the number of lesions was fewer than 6 in 3, between 6 and 20 in 1 and more than 20 in 4 patients. Each MET uptake score was higher than the FDG uptake score in medullary lesions except for only one lesion. In 7 of 8 patients, many obvious medullary lesions on MET-PET were missed by FDG-PET. Of the 3 extramedullary lesions, 2 were missed by FDG-PET and 1 was missed by CT before the MET-PET. There was only one case of solitary plasmacytoma (non-secretory) showing higher FDG uptake score than the MET uptake score (FDG=2+, MET=1+). This finding was probably due to low utilization of MET to the monoclonal protein within the tumor. No accumulations of FDG and MET were seen in one case of MGUS without bone lesions.

Conclusions: MET-PET can locate secreting active lesions of myeloma which were often missed by FDG-PET. MET-PET is very useful for evaluating secretory multiple myeloma.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Kanegae, K.
Right arrow Articles by Tamaki, N.
PubMed
Right arrow Articles by Kanegae, K.
Right arrow Articles by Tamaki, N.