Author(s): Elliott BM, Peti S, Osman K, Scigliano E, Lee D,
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Abstract OBJECTIVES: The precise role of positron emission tomography (PET/CT) for predicting relapse/progression in multiple myeloma remains uncertain. We compared the predictive values of PET/CT, concurrent laboratory testing (labs), and their combination in prediction of 12-month progression, as determined by current International Myeloma Working Group (IMWG) criteria. METHODS: PET/CT and labs (serum chemistry, β2-microglobulin, immunofixation, bone marrow biopsy, serum free light chains) were reviewed, and date of relapse/progression was determined by IMWG criteria. RESULTS: The median time from therapy to PET/CT imaging was 12.0 months (1.0-110) and median time to progression (TTP) was 29.8 months (1.6-130+). Overall survival and survival-without-progression at last follow-up were 84\% and 49\%, respectively. Sensitivity of PET/CT for predicting relapse/progression was lower than that of labs (0.67 vs. 0.89, ns), but PET/CT was more specific (0.89 vs. 0.79, ns). When labs and PET/CT data were combined, a positive result for either test was 89\% sensitive and a positive result for both tests was 100\% specific for predicting 12-month progression of disease. Kaplan-Meier analysis showed significantly greater TTP for those with a negative vs. positive PET/CT (P = 0.0005), negative vs. positive labs (P < 0.0001), and both tests negative vs. both tests positive (P < 0.0001). CONCLUSIONS: Combining PET/CT with laboratory data improves the accuracy of prediction of relapse/progression within 12 months compared with each test alone. Thus, integration of PET/CT into myeloma follow-up is recommended, and the impact of this approach on management should be explored. © 2011 John Wiley & Sons A/S.
This article was published in Eur J Haematol
and referenced in Journal of Nuclear Medicine & Radiation Therapy