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<p>The co-primary aims of this study were to assess the diagnostic and prognostic performance of Whole-body-2-[<sup>18</sup>F]-fluorodeoxyglucose-positron emission tomography coupled with MRI (WB-2-[<sup>18</sup>F]FDG-PET/MRI) imaging in the smoldering multiple myeloma (SMM) workup for detection of MM-related medullary or extra-medullary disease and for the prediction of progression-free survival (PFS) defined as time to progression to symptomatic MM requiring therapy. A total of 116 patients with SMM (without CRAB or SLiM criteria before imaging) were prospectively included in the study and underwent full multi-parametric WB-2-[<sup>18</sup>F]FDG-PET/MRI imaging. PET detected at least one FL &gt; 5 mm in 9% of patients compared to 20% on MRI (<i>p </i>= 0.02). PET detected diffuse bone marrow involvement (BMI) in 20% of patients and MRI in 53% (<i>p </i>&lt; 10<sup>−3</sup>). A total of 98 patients with true SMM not requiring treatment were then followed up. The presence of diffuse BMI on MRI was the strongest adverse prognostic parameter for PFS (univariate: hazard ratio (HR), 6.12; <i>p </i>&lt; 10<sup>−2</sup>. Multivariate : HR, 4.16; <i>p </i>= 0.03) and could be proposed as a new high-risk biomarker for progression to symptomatic MM. Dynamic contrast-enhanced (DCE)-MRI based increased peak enhancement intensity (PEI) and maximum intensity time ratio (MITR) values were other strong adverse prognostic factors.</p>

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Simultaneous whole-body multi-parametric 2-[18F]FDG-PET/MRI in smoldering multiple myeloma assessment: diagnostic and prognostic impact

  • 期刊论文

  • 发表日期：

    2025年8月7日

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  • Bastien Jamet,
  • Cyrille Touzeau,
  • Hatem Necib,
  • Éric Frampas,
  • Huajun Sun,
  • Chloe Francois,
  • Nicolas Blin,
  • Thomas Carlier,
  • Aurélien Monnet,
  • Nicoletta Lilli,
  • Caroline Bodet-Milin,
  • Philippe Moreau,
  • Françoise Kraeber-Bodere

摘要

The co-primary aims of this study were to assess the diagnostic and prognostic performance of Whole-body-2-[18F]-fluorodeoxyglucose-positron emission tomography coupled with MRI (WB-2-[18F]FDG-PET/MRI) imaging in the smoldering multiple myeloma (SMM) workup for detection of MM-related medullary or extra-medullary disease and for the prediction of progression-free survival (PFS) defined as time to progression to symptomatic MM requiring therapy. A total of 116 patients with SMM (without CRAB or SLiM criteria before imaging) were prospectively included in the study and underwent full multi-parametric WB-2-[18F]FDG-PET/MRI imaging. PET detected at least one FL > 5 mm in 9% of patients compared to 20% on MRI (p = 0.02). PET detected diffuse bone marrow involvement (BMI) in 20% of patients and MRI in 53% (p < 10−3). A total of 98 patients with true SMM not requiring treatment were then followed up. The presence of diffuse BMI on MRI was the strongest adverse prognostic parameter for PFS (univariate: hazard ratio (HR), 6.12; p < 10−2. Multivariate : HR, 4.16; p = 0.03) and could be proposed as a new high-risk biomarker for progression to symptomatic MM. Dynamic contrast-enhanced (DCE)-MRI based increased peak enhancement intensity (PEI) and maximum intensity time ratio (MITR) values were other strong adverse prognostic factors.