Prospective Pilot Study of ¹¹C-acetate and ¹⁸F-FDG with PET/CT and PET/MRI for Lesion Detection in Multiple Myeloma

To compare the diagnostic performance of ¹¹C-acetate and ¹⁸F-FDG across hybrid PET/CT and PET/MRI platforms in patients with multiple myeloma (MM).

In this prospective pilot study, seven patients with MM underwent repeated-measures imaging with ¹⁸F-FDG PET/CT, ¹⁸F-FDG PET/MRI, ¹¹C-acetate PET/CT, and ¹¹C-acetate PET/MRI. In addition to lesion quantification, the lesions were visually scored for conspicuity. No functional sequences or contrast-enhancement was used in the MRI protocol.

¹¹C-acetate detected a greater number of lesions and demonstrated higher visual conspicuity than ¹⁸F-FDG across both PET/CT and PET/MRI platforms.

¹¹C-acetate PET imaging may offer improved lesion detection compared to ¹⁸F-FDG in MM. Although the advantage of PET/MRI was not observed over PET/CT in this context, further studies incorporating additional MRI sequences and larger cohorts are warranted.