In multiple myeloma (MM) patients, 18F-FDG-PET/CT allows either the detection of disease spread by using visual parameters based on the Italian Myeloma criteria for PET Use (IMPeTUs) or the direct measurement of metabolic tumor burden by volume-based parameters such as metabolic tumor volume (MTV). The purpose is to evaluate the contribution of visual and volumetric parameters in the prediction of progression-free survival (PFS) and overall survival (OS) in MM patients. Forty-seven patients in stage IIIA who had undergone whole-body 18F-FDG-PET/CT were retrospectively evaluated. In each patient, visual parameters were determined and compared with volumetric parameters for PFS and OS prediction after a mean follow-up period of 53 months. Among the visual and volumetric parameters tested, a statistically significant difference was found between maximum standardized uptake value, MTV, total lesion glycolysis, and number of lytic lesions of patients with (n = 26) or without (n = 21) progression (p = 0.0400, p = 0.0065, p = 0.015, and p = 0.0220, respectively) and of dead (n = 24) vs survivors (n = 23) (p = 0.0171, p = 0.0037, p = 0.0060, and p = 0.0270, respectively). At univariate and multivariate analysis, MTV and hemoglobin were predictive of both PFS (p = 0.008) and OS (p = 0.0026). The best MTV discriminative value assessed by receiver operating characteristic curve analysis for predicting both PFS and OS was 39.4 ml. By Kaplan-Meier analysis and log-rank test, PFS and OS were significantly better in patients with MTV ≤ 39.4 ml (p = 0.0004 and p = 0.0001, respectively) as compared with those having an MTV higher than the cutoff. The volume-based parameter MTV determined by 18F-FDG-PET/CT may be used in the prediction of PFS and OS in myeloma patients.

中文翻译：

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18F-FDG-PET / CT的视觉和体积参数：多位骨髓瘤患者预后的正面对比。

在多发性骨髓瘤（MM）患者中，18F-FDG-PET / CT允许通过使用基于意大利PET骨髓瘤标准（IMPeTUs）的视觉参数检测疾病扩散，或通过基于体积的直接测量代谢性肿瘤负荷代谢肿瘤体积（MTV）等参数。目的是评估视觉和容积参数对MM患者无进展生存期（PFS）和总体生存期（OS）的预测。回顾性分析了IIIA期的47例患者，这些患者均接受了全身18F-FDG-PET / CT检查。平均随访53个月后，确定每位患者的视觉参数，并将其与PFS和OS预测的体积参数进行比较。在测试的视觉和体积参数中，在进展（n = 26）或没有进展（n = 21）的患者中，最大标准化摄取值，MTV，总病变糖酵解和溶解性病变的数量之间存在统计学差异（p = 0.0400，p = 0.0065，p =死者（n = 24）与幸存者（n = 23）分别为0.015和p = 0.0220）和死亡（n = 24）（p = 0.0171，p = 0.0037，p = 0.0060和p = 0.0270）。在单变量和多变量分析中，MTV和血红蛋白可预测PFS（p = 0.008）和OS（p = 0.0026）。通过接收器工作特性曲线分析评估的最佳MTV判别值可预测PFS和OS均为39.4 ml。通过Kaplan-Meier分析和对数秩检验，与MTV高于临界值的患者相比，MTV≤39.4 ml的患者（分别为p = 0.0004和p = 0.0001）的PFS和OS明显更好。