Relation of whole-body metabolic tumor volume and total lesion glycolysis on fluorodeoxyglucose PET/computed tomography with clinical and laboratory parameters in newly diagnosed multiple myeloma

Objective: This study aims to evaluate the relationships of metabolic fluorodeoxyglucose PET/computed tomography (FDG PET/CT) parameters such as whole-body metabolic tumor volume (WB MTV), WB-total lesion glycolysis (TLG), and bone marrow (BM)-mean standard uptake value (SUVmean) with clinical stage and other prognostic biomarkers in newly diagnosed multiple myeloma (MM) patients.

Methods: Patients who underwent pretreatment PET/CT with the diagnosis of MM were evaluated retrospectively. The number of focal lesions, WB MTV, WB TLG, and BM SUVmean values were measured on FDG PET/CT images. Clinical stages and prognostic laboratory parameters were recorded the pretreatment period.

Results: WB MTV and WB TLG values were significantly higher in patients with more than three focal lesions on FDG PET/CT scan (all P < 0.001). According to the Revised International Staging System (R-ISS), all WB MTV, WB TLG, and BM SUVmean values are significantly higher in patients with stage 3 disease than in stages 1-2 ( P = 0.027, P = 0.019, P = 0.001, respectively). Serum creatinine level is positively correlated with WB MTV, WB TLG, and BM SUVmean values ( P = 0.020, P = 0.004, P < 0.001, respectively). In addition, the β2 microglobulin level, an essential biochemical prognostic parameter, was positively correlated with the BM SUVmean value ( P = 0.013).

Conclusion: The BM SUVmean, WB MTV, and WB TLG values, which reflect FDG avid WB tumor burden, are associated with prognostic biomarkers and R-ISS stage in newly diagnosed MM patients. It contributes to the identification of high-risk patients at the pretreatment staging.