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[ $^{18}F-FDG$ ] PET/CT in Multiple Myeloma: Is It Necessary to Include the Skull and Lower Extremity Distal to Mid-Thigh?  

Lee, Su-Jin (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Joon-Young (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Ki-Hyun (Departments of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Eun-Jeong (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Cho, Young-Seok (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Hyun, Seung-Hyup (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Ji-Young (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Kyung-Han (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Byung-Tae (Departments of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.42, no.1, 2008 , pp. 39-43 More about this Journal
Abstract
Purpose: We evaluated whether it was necessary to perform whole body acquisition of $^{18}F$-FDG PET/CT including whole skull and lower extremity (LE) distal to mid-thigh (MT) in patients with multiple myeloma (MM). Materials and Methods: Thirty patients underwent 45 whole body $^{18}F$-FDG PET/CT scans including skull and LE distal to MT. PET scans were divided by 2 subgroups according to the presence of abnormal focal $^{18}F$-FDG uptake in skull or LE distal to MT. Clinical characteristics including age, sex, and stages were compared between the 2 subgroups. Results: Of total 45 whole body PET/CT scans, focally increased abnormal FDG uptake in the skull or LE distal to MT suggesting myeloma involvement was found in 22 scans (48.9%) of 14 patients (46.7%). Skull lesions were more frequently observed than LE lesions distal to MT on PET (86.4% vs. 40.9%, p<0.005). There were no significant differences in age, sex, initial Durie/Salmon stage, and tumor burden at the time of PET scan suggested by serum hemoglobin level, serum calcium level, serum and urine paraprotein level, and serum creatinine level between the two subgroups. The presence of the skull or LE distal MT lesions on PET did not affect on the Durie/Salmon plus stage except only 1 case (1/22, 4.5%, p>0.05). Conclusion: Abnormal lesions in the skull or LE distal to MT on $^{18}F$-FDG PET/CT did not affect significantly on the tumor burden and Durie/Salmon plus stage of MM. Therefore, torso PET acquisition including head may be sufficient for evaluating patients with MM.
Keywords
multiple myeloma; $^{18}F-FDG$; PET/CT; whole body acquisition; torso acquisition;
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