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Updated: Feb 3, 2026

Establishment of a Human Multiple Myeloma Xenograft Model in the Chicken to Study Tumor Growth, Invasion and Angiogenesis
Published on: May 1, 2015
Hexokinase-2 Expression in 11C-Methionine-Positive, 18F-FDG-Negative Multiple Myeloma
Stefan Kircher1,2, Antje Stolzenburg3, Klaus Martin Kortüm4
1Institute of Pathology, University of Würzburg. Würzburg, Germany.
Abstract:
PET with 18F-FDG is the standard modality in nuclear medicine for imaging multiple myeloma (MM). However, viable MM as detected by MRI or PET with other metabolic tracers, including 11C-methionine, may be missed-for example, because of low hexokinase 2 (HK2) expression of tumor cells. The aim of this study was to further investigate potential reasons for PET false negativity. Methods: A cohort of 15 mainly pretreated patients with relapsed or refractory biopsy-proven, serologically active MM who underwent both 18F-FDG and 11C-methionine PET/CT was retrospectively analyzed. Results: In 9 of the 15 patients, 18F-FDG PET was negative in the presence of viable disease. In the remaining 6 patients, both 18F-FDG and 11C-methionine PET/CT revealed the same number of MM lesions. At immunohistochemistry, 18F-FDG-negative myeloma did not exhibit significant differences in HK2 or glucose-6-phosphatase expression from 18F-FDG-positive disease (P = 0.57 and P = 0.44, respectively). Conclusion: Beyond HK2 expression, 18F-FDG negativity in (mainly pretreated) MM patients seems to be associated with additional causes not yet known.
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