PET/CT Imaging for Therapy Assessment in Multiple Myeloma Including MRD

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Multiple myeloma (MM) is a hematologic malignancy involving abnormal plasma cell proliferation.
• [18F]FDG PET/CT offers high sensitivity and specificity for detecting metabolically active MM.
• This review focuses on PET/CT's role in evaluating MM treatment response and minimal residual disease (MRD).

Purpose of the Study:

• To review the literature on PET/CT imaging for assessing treatment response in symptomatic multiple myeloma.
• To examine the utility of PET/CT in evaluating minimal residual disease (MRD) in MM.
• To explore the role of PET/CT in therapeutic decision-making and risk stratification for MM patients.

Main Methods:

• Literature search of PubMed, Scopus, Web of Science, and Cochrane Library (2014-2024).
• Inclusion of peer-reviewed articles evaluating PET imaging in MM treatment response assessment.
• Focus on studies assessing therapeutic response and MRD in symptomatic myeloma.

Main Results:

• [18F]FDG PET/CT enables whole-body disease assessment, detection of extramedullary involvement, and early metabolic response evaluation.
• Standardized criteria (Deauville, IMPeTUs, IMWG) improve reproducibility and accuracy of treatment monitoring.
• PET negativity correlates with improved progression-free and overall survival; integration with bone marrow techniques optimizes MRD assessment.

Conclusions:

• PET/CT is a valuable tool for enhancing therapeutic decision-making and risk stratification in MM management.
• Emerging radiotracers ([11C]choline, [11C]methionine, [68Ga]pentixafor, immunoPET tracers) show promise for advanced diagnostic capabilities.
• PET/CT integration with other techniques optimizes MRD evaluation and patient stratification for personalized MM treatment.