SNM Annual Meeting Abstracts
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     



J Nucl Med. 2008; 49 (Supplement 1):339P
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 Philips, S.
Right arrow Articles by Niesvizky, R.
PubMed
Right arrow Articles by Philips, S.
Right arrow Articles by Niesvizky, R.

Oncology-Clinical Diagnosis: Hematologic Tumors

Hematology Malignancy

Utility of decreased FDG SUV as a response and prognostic indicator in multiple myeloma therapy with BiRD

Shibu Philips2, Stanley Goldsmith1, David Jayabalan1, Morton Coleman1 and Ruben Niesvizky1

1 Nuclear Medicine, NYPH-Weill Cornell, New York, New York; 2 Radiology, Bronx Lebonon Hosp., Bronx, New York

1436

Objectives: To assess the utility of post-treatment [Rx] FDG SUV decrease from pre-Rx SUV as an indicator of response & prognosis [IRP] in Multiple Myeloma [MM] patients [pts] receiving BiRD therapy.

Methods: 11 pts [6 M; 5 F] with active clinical and serologic MM [Salmon-Dury Class IIa (4), IIIa (6), III (1)] had FDG PET/CT pre and post BiRD Rx. Iliac bone [IB] and Index Lesion [IL] SUV obtained from images 60 min post 12-15 mCi FDG pre & post BiRD [Biaxin, Revlimid & Dexamethasone [D], 40 mg on day 1, 2,3,8,15 and 22]. BiRD is an innovative 23 day immunomodulator regimen in clinical trials for MM Rx. Pre and post Rx interval varied from 3-12 months (median 7) depending on pts ability to tolerate protocol. Initial PET obtained before Rx for 9 pts, 3-18 days post-Rx for 3 pts. Post-Rx PET obtained from 49 days before Rx completion to 153 days after.

Results: 4 pts had CR; 4 PR; 3 minimal Response [mR]. Mean pre Rx SUV for CR: Rt IB/Lt IB/IL =3.9, 3.9, 6.7; PR = 5.1, 3.9, 9.3; mR = 3.5, 3.7, 3.6. Mean Post-Rx SUV: CR = 2.1, 2.2, 2.5; PR = 2.2, 2.1, 5.2; mR = 2.9, 2.4, 1.7. % Change SUV for CR = 46, 41, 44; PR = 50, 46, 54; mR = 0, 37, 49. 1 outlier; otherwise average 36%. Bony index lesions involved pelvis (7), T spine (2), L spine (1) & rib (1). 1 pt with abdominal plasmacytoma. Iliac bone SUV used given high likelihood of MM involvement and as proxy for bone marrow.

Conclusions: Whereas post Rx SUV change is a promising IRP in many tumors, it was not useful in MM pts Rx with BiRD. 41-54% SUV decrease was seen regardless of clinical response. BiRD involves high doses of D which inhibits tumor glucose utilization. Effect of D dose and interval to FDG PET is undetermined in MM. Steroid administration may be another variable affecting FDG SUV.

Research Support: Celgene





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 Philips, S.
Right arrow Articles by Niesvizky, R.
PubMed
Right arrow Articles by Philips, S.
Right arrow Articles by Niesvizky, R.