Diagnostic relevance of 2‐[18F]‐FDG PET/CT in patients recently diagnosed with monoclonal gammopathy of undetermined significance

• Published in: Hematological oncology Vol. 41; no. 3; pp. 434 - 441
• Main Authors: Rudolphi‐Solero, Teodoro, Triviño‐Ibáñez, Eva María, González‐Jiménez, Antonio Daniel, Ramos‐Font, Carlos, Ríos‐Tamayo, Rafael, Rebollo‐Aguirre, Angel Custodio, Sánchez‐Sánchez, Rocío
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.08.2023
• Subjects: 2‐[18F]‐FDG PET/CT; Benign monoclonal gammopathy; Body mass; Body mass index; Body size; Bone lesions; Cardiovascular diseases; Computed tomography; Diagnostic systems; Evaluation; Fluorine isotopes; Health risks; Lesions; monoclonal component rate; monoclonal gammopathy of undetermined significance; Multiple myeloma; multiple myeloma progression risk; Positron emission tomography; Process parameters; Regression analysis; Risk factors; Sensitivity; Soft tissues; monoclonal component rate; monoclonal gammopathy of undetermined significance; 2-[18F]-FDG PET/CT; multiple myeloma progression risk
• ISSN: 0278-0232; 1099-1069
• DOI: 10.1002/hon.3085

2‐[18F]‐FDG PET/CT is a useful diagnostic technique to assess bone and soft tissue disease in multiple myeloma (MM) but is not recommended by the International Myeloma Working Group for the evaluation of monoclonal gammopathy of undetermined significance (MGUS). The objective of this study was to evaluate the role of 2‐[18F]‐FDG PET/CT in the management of these patients. An observational retrospective study was conducted on 338 patients with MGUS who underwent 2‐[18F]‐FDG PET/CT. The mean age was 70.80 ± 11.84 years, and 69.2% of patients had cardiovascular risk factors. Patients were classified according to their progression risk (Mayo Clinic). The mean post‐diagnosis follow‐up was 8.35 ± 14.46 months. Pathological findings were recorded in 49 patients: 30 with myeloma bone lesions (15 in the initial study and 15 in follow‐up) and 19 with other neoplastic (n = 13) or pathologically significant findings (n = 6). Body mass index, monoclonal component rate (MCR) > 1 g/dL and ≥1 risk factors for MM were significant in univariate logistic regression analyses. The MCR emerged as the main predictor of a positive 2‐[18F]‐FDG PET/CT in adjusted multivariate regression analysis, with an area under the receiver operating characteristic curve of 0.785 and cutoff for optimal sensitivity/specificity of 1.0 ng/mL (71.4% sensitivity, 71.2% specificity). 2‐[18F]‐FDG PET/CT results correctly classify patients with MGUS and could improve the detection of bone lesions over existing techniques, with the additional possibility of detecting neoplastic processes. The best parameter to predict a positive 2‐[18F]‐FDG PET/CT was the MCR.