Sandra S. Win MD, Presenter: Nothing to Disclose

Andrew Quon MD, Abstract Co-Author: Research grant, Genentech, Inc

Sanjiv S. Gambhir MD, PhD, Abstract Co-Author: Board of Directors, Lumera Corporation Stockholder, Lumera Corporation Stockholder, Pfizer Inc Consultant, Spectrum Dynamics Ltd Stockholder, Spectrum Dynamics Ltd Grant, Johnson & Johnson Committee member, Amgen Inc Scientific Advisory Board, Novartis AG Scientific Advisory Board, Siemens AG Royalties, Reed Elsevier Scientific Advisory Board, Genentech, Inc Scientific Advisory Board, General Electric Company Grant, General Electric Company Research collaboration, GlaxoSmithKline plc Scientific Advisory Board, GlaxoSmithKline plc Scientific Advisory Board, Intronn Inc Research collaboration, Intronn Inc Grant, Intronn Inc Scientific Advisory Board, Lumen Therapeutics Consultant, MediGene AG Scientific Advisory Board, MediGene AG Consultant, Millennium Pharmaceuticals, Inc Research collaboration, Pfizer Inc Grant, Pfizer Inc Consultant, Koninklijke Philips Electronics NV Scientific Advisory Board, Koninklijke Philips Electronics NV Consultant, Pathwork Diagnostics Grant, Bayer AG Speaker, Siemens AG Scientific Advisory Board, Varian Medical Systems, Inc Scientific Advisory Board, VisualSonics Inc

Robert J. Herfkens MD, Abstract Co-Author: Nothing to Disclose

This purpose of this poster is to demonstrate the value of F-18 FDG PET/CT in the staging and management of multiple myeloma and plasmacytoma.

1. Retrospective search of Stanford Univ Hospital PET/CT database, between Jan. 2003 and March 1, 2009, performed. 2. Electronic chart review yielded 11 patients with biopsy confirmed multiple myeloma (MM) and plasmacytoma (PM): numbering (7) and (4). 3. 5 were female and 6 were male. 4. Median age was 64 years, with range 50 to 75 yrs. 5. PET/CT performed for staging (1 pt) and for monitoring response to therapy or restaging (10 pts). 6. Correlation made with bone and bone marrow biopsy, flow cytometry, and other imaging (skeletal survey, CT, MRI) to confirm true positive and true negatives.

1. A total of 11 patients and a total of 22 PET/CT's with 38 lesions 2. 5 had negative PET/CT's or Complete Response to therapy. 3. 1 had Nearly Complete Response with faint FDG uptake. 4. 2 had mixed or Partial Response. 5. 1 had Progressive Disease. 6. 1 had biopsy confirmed disease (Initial Staging Positive). 7. 1 had No Response to therapy. 8. Of the 6 patients with positive PET/CT's, there were a total of 11 PET/CT studies and 26 lesions with 3 lesions representing focal disease and the remaining 23 lesions representing diffuse disease. 9. Of the 26 lesions, maximum Standard Uptake Value (SUV) ranged from 1.5 to 8.2. 10. 2 out of 6 patients had solitary PM on PET/CT's. 11. 1 out of 6 pts. had PM and MM on PET/CT's. 12. 3 out of 6 pts. had diffuse MM on PET/CT's. 13. Of the 5 pts. with negative PET/CT's, there were a total of 11 PET/CT's and 12 non-FDG avid lesions. 14. Correlation with bone marrow Biopsy showed 2 False Positives (FP) but no False Negatives (FN). 15. Sensitvity of 100% and Specificity of 85.7% were calculated for FDG PET/CT in this small study, which may be limited by sample size and patient selection bias.

1. PET/CT aided clinical management by detecting focal as well as diffuse myeloma in our study. 2. PET/CT can stage and monitor myeloma and may play a future role in monitoring patients with non-secretory or hypo-secretory myeloma.

F-18 FDG PET/CT demonstrates value in imaging multiple myeloma and plasmactyoma.

Win, S, Quon, A, Gambhir, S, Herfkens, R, F-18 FDG PET/CT Imaging of Myeloma.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8013716.html