Choline PET/CT in Multiple Myeloma.
Charles Mesguich1,2, Cyrille Hulin3, Axelle Lascaux3
1CHU Bordeaux, Nuclear Medicine Department, F-33000 Bordeaux, France.
Cancers
|June 3, 2020
Summary
Choline PET/CT may detect up to 75% more multiple myeloma lesions than FDG PET/CT. This novel imaging approach offers improved visualization and sensitivity for staging and monitoring multiple myeloma patients.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Multiple myeloma (MM) imaging has advanced with new radiotracers.
- 18F-fluorodeoxyglucose (18FDG) PET/CT is recommended for MM staging and response assessment.
- 18FDG PET/CT has limitations, including poor sensitivity for skull lesions and a 10% false-negative rate in MM patients.
Purpose of the Study:
- To review the role of Choline PET/CT in multiple myeloma.
- To compare Choline PET/CT with 18FDG PET/CT for MM imaging.
- To discuss Choline physiopathology and clinical data in MM.
Main Methods:
- Review of clinical studies comparing 18F-Fluorocholine or 11C-Choline PET/CT with 18FDG PET/CT in MM patients.
- Analysis of Choline uptake patterns and comparison with 18FDG uptake in MM lesions.
- Evaluation of the diagnostic performance of Choline tracers versus 18FDG.
Main Results:
- Choline tracers show higher uptake in the majority of MM lesions compared to 18FDG.
- Choline PET/CT can improve lesion visualization with a higher tumor-to-background ratio.
- Choline PET/CT may detect up to 75% more lesions than 18FDG PET/CT, particularly in refractory or relapsed MM.
Conclusions:
- Choline-based tracers offer potential advantages over 18FDG for MM imaging.
- Choline PET/CT may enhance the detection and characterization of multiple myeloma lesions.
- Further research is needed to fully establish the role of Choline PET/CT in MM management, acknowledging limitations such as liver lesion visualization.
