Predictive value of 18 F-FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma.

Objective: To evaluate the association of F-18-2'-deoxy 2'-fluorodeoxyglucose (F-18-FDG) PET/CT with clinical parameters in predicting patients with newly diagnosed multiple myeloma (MM). Methods: A total of 120 MM patients undergoing F-18-FDG PET/CT scanning were analyzed in a retrospective cohort study. Results: Based on multivariate analysis, beta 2M, LDH, number of focal lesions (FLs), and SUVmax were significantly correlated with OS. These 4 variables were used to construct a new staging system (NSS) based on the number of risk factors. NSS provided a better discrimination of risk between stages III and II than International staging system (ISS) (P < .001 vs P = .086). For OS, there was no significant difference among risk groups in Durie-Salmon (DS) stage (P > .05). Based on Spearman correlation analysis, the presence of lesions in appendicular skeleton, number of FLs, and SUVmax appeared to indicate advanced stage of MM. ROC curves which showed the combination of beta 2M with calcium got a specificity of 96.3% for lesions in appendicular skeleton, and LDH alone had 100% specificity in predicting the number of FLs, although the sensitivity was only 50%. Conclusions: F-18-FDG PET/CT in combination with clinical parameters provided an accurate and simple method for risk stratification of patients with newly diagnosed MM.