A First Report on [¹⁸F]FPRGD₂ PET/CT Imaging in Multiple Myeloma

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Multiple myeloma (MM) diagnosis and staging rely on accurate lesion detection.
• Novel imaging agents are needed to improve the detection and characterization of MM bone lesions.

Purpose of the Study:

• To evaluate the feasibility of [¹⁸F]FPRGD₂ PET/CT for imaging multiple myeloma.
• To compare the detection rate of [¹⁸F]FPRGD₂ PET/CT with low-dose CT and combined [¹⁸F]NaF/[¹⁸F]FDG PET/CT in MM patients.

Main Methods:

• Observational study involving four MM patients (2 newly diagnosed, 2 relapsed).
• Whole-body PET/CT imaging after [¹⁸F]FPRGD₂ injection.
• Comparison of [¹⁸F]FPRGD₂ PET/CT findings with low-dose CT and existing [¹⁸F]NaF/[¹⁸F]FDG PET/CT data.

Main Results:

• A total of 81 focal lesions (FLs) were identified across all imaging modalities.
• [¹⁸F]FPRGD₂ PET/CT detected fewer FLs (54%) compared to low-dose CT (98%) and [¹⁸F]NaF/[¹⁸F]FDG PET/CT (70%).
• All lesions detected by [¹⁸F]FPRGD₂ PET/CT showed underlying bone destruction or fracture and were also visible on low-dose CT.

Conclusions:

• [¹⁸F]FPRGD₂ PET/CT may have limited utility for detecting multiple myeloma lesions, particularly in advanced disease.
• Low-dose CT alone detected a higher proportion of lesions than [¹⁸F]FPRGD₂ PET/CT.
• Further research is needed to determine the specific role of [¹⁸F]FPRGD₂ in MM imaging.