CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT
Introduction/Justification: ¹⁸F-FDG PET/CT is widely used in the management of multiple myeloma (MM), a disease that often presents with extensive bone involvement. Radiolabeled prostate-specific membrane antigen (PSMA), primarily a marker for prostate cancer, is also associated with tumor neoangiog...
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Elsevier
2025-05-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137925000719 |
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| author | Alexandre Mercuri Barbosa Maria Emília Seren Takahashi Stephan Pinheiro Macedo Souza Edna Marina Souza Sérgio Querino Brunetto Cármino Antonio de Souza Irene Gyongyver Heidemarie Lorand-Metze Celso Darío Ramos |
| author_facet | Alexandre Mercuri Barbosa Maria Emília Seren Takahashi Stephan Pinheiro Macedo Souza Edna Marina Souza Sérgio Querino Brunetto Cármino Antonio de Souza Irene Gyongyver Heidemarie Lorand-Metze Celso Darío Ramos |
| author_sort | Alexandre Mercuri Barbosa |
| collection | DOAJ |
| description | Introduction/Justification: ¹⁸F-FDG PET/CT is widely used in the management of multiple myeloma (MM), a disease that often presents with extensive bone involvement. Radiolabeled prostate-specific membrane antigen (PSMA), primarily a marker for prostate cancer, is also associated with tumor neoangiogenesis, and studies have demonstrated its uptake in MM lesions. Hybrid PET/CT imaging with both FDG and PSMA tracers allows for several quantitative metrics, enabling objective comparisons beyond visual analysis. Objectives: This study aims to compare ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT quantitative metrics in the skeletal system of patients with MM. Materials and Methods: The study included ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT images acquired within a 1- to 8-day interval from 15 patients (53% male, mean age 66.7 ± 10.7 years) with symptomatic, biopsy-proven MM. CT was used to segment the entire skeleton in PET images, with the skull excluded in ¹⁸F-FDG images due to artifacts from brain uptake coregistration. SUV quantification was performed using in-house software developed in MATLAB. Descriptive statistics and individual percentage deviations between the radiotracers were used to evaluate bone mean and maximum Standardized Uptake Values (SUVmean and SUVmax). Correlation analysis between the radiotracers was conducted using Spearman's rank correlation coefficient (r) with a significance level of p < 0.05. Results: For bone SUVmean, values were higher for ¹⁸F-FDG compared to ⁶⁸Ga-PSMA, with an average of 0.9 ± 0.1 vs. 0.5 ± 0.1, corresponding to a -40% ± 9% difference (range: -25% to -57%). Conversely, for bone SUVmax, values were lower for ¹⁸F-FDG compared to ⁶⁸Ga-PSMA, with an average of 8 ± 3 vs. 19 ± 14, corresponding to a 154% ± 2% difference (range: -21% to 762%). A moderate correlation was found for bone SUVmean between ¹⁸F-FDG and ⁶⁸Ga-PSMA (r = 0.55, p = 0.03), while no significant correlation was observed for bone SUVmax (r = 0.17, p = 0.55). Conclusion: This study reveals distinct quantitative uptake patterns between ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT in the skeletal system of MM patients. ¹⁸F-FDG exhibited significantly higher SUVmean than ⁶⁸Ga-PSMA, likely due to physiological ¹⁸F-FDG uptake in bone marrow. A moderate correlation was observed for SUVmean between the two tracers. The higher SUVmax values for ⁶⁸Ga-PSMA, with no correlation with ¹⁸F-FDG SUVmax, may reflect the different biological targeting mechanisms of each tracer. This suggests that some regions of increased PSMA uptake (possibly indicating neoangiogenesis) may not correspond to areas of increased glycolysis, highlighting the potential complementary role of these radiotracers in MM evaluation. |
| format | Article |
| id | doaj-art-41d9be85b76a4dd6b157b1fa13d67f3c |
| institution | OA Journals |
| issn | 2531-1379 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj-art-41d9be85b76a4dd6b157b1fa13d67f3c2025-08-20T02:17:33ZengElsevierHematology, Transfusion and Cell Therapy2531-13792025-05-014710380310.1016/j.htct.2025.103803CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CTAlexandre Mercuri Barbosa0Maria Emília Seren Takahashi1Stephan Pinheiro Macedo Souza2Edna Marina Souza3Sérgio Querino Brunetto4Cármino Antonio de Souza5Irene Gyongyver Heidemarie Lorand-Metze6Celso Darío Ramos7Division of Nuclear Medicine, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Centro de Engenharia Biomédica (CEB), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilInstituto de Física Gleb Wataghin, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Cancer Theranostics Innovation Center (CancerThera), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilDivision of Nuclear Medicine, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilCentro de Engenharia Biomédica (CEB), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Cancer Theranostics Innovation Center (CancerThera), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilCentro de Engenharia Biomédica (CEB), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Cancer Theranostics Innovation Center (CancerThera), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilCancer Theranostics Innovation Center (CancerThera), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Hemocentro, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilHemocentro, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilDivision of Nuclear Medicine, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Cancer Theranostics Innovation Center (CancerThera), Universidade Estadual de Campinas (UNICAMP), Campinas, SP, BrazilIntroduction/Justification: ¹⁸F-FDG PET/CT is widely used in the management of multiple myeloma (MM), a disease that often presents with extensive bone involvement. Radiolabeled prostate-specific membrane antigen (PSMA), primarily a marker for prostate cancer, is also associated with tumor neoangiogenesis, and studies have demonstrated its uptake in MM lesions. Hybrid PET/CT imaging with both FDG and PSMA tracers allows for several quantitative metrics, enabling objective comparisons beyond visual analysis. Objectives: This study aims to compare ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT quantitative metrics in the skeletal system of patients with MM. Materials and Methods: The study included ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT images acquired within a 1- to 8-day interval from 15 patients (53% male, mean age 66.7 ± 10.7 years) with symptomatic, biopsy-proven MM. CT was used to segment the entire skeleton in PET images, with the skull excluded in ¹⁸F-FDG images due to artifacts from brain uptake coregistration. SUV quantification was performed using in-house software developed in MATLAB. Descriptive statistics and individual percentage deviations between the radiotracers were used to evaluate bone mean and maximum Standardized Uptake Values (SUVmean and SUVmax). Correlation analysis between the radiotracers was conducted using Spearman's rank correlation coefficient (r) with a significance level of p < 0.05. Results: For bone SUVmean, values were higher for ¹⁸F-FDG compared to ⁶⁸Ga-PSMA, with an average of 0.9 ± 0.1 vs. 0.5 ± 0.1, corresponding to a -40% ± 9% difference (range: -25% to -57%). Conversely, for bone SUVmax, values were lower for ¹⁸F-FDG compared to ⁶⁸Ga-PSMA, with an average of 8 ± 3 vs. 19 ± 14, corresponding to a 154% ± 2% difference (range: -21% to 762%). A moderate correlation was found for bone SUVmean between ¹⁸F-FDG and ⁶⁸Ga-PSMA (r = 0.55, p = 0.03), while no significant correlation was observed for bone SUVmax (r = 0.17, p = 0.55). Conclusion: This study reveals distinct quantitative uptake patterns between ¹⁸F-FDG and ⁶⁸Ga-PSMA PET/CT in the skeletal system of MM patients. ¹⁸F-FDG exhibited significantly higher SUVmean than ⁶⁸Ga-PSMA, likely due to physiological ¹⁸F-FDG uptake in bone marrow. A moderate correlation was observed for SUVmean between the two tracers. The higher SUVmax values for ⁶⁸Ga-PSMA, with no correlation with ¹⁸F-FDG SUVmax, may reflect the different biological targeting mechanisms of each tracer. This suggests that some regions of increased PSMA uptake (possibly indicating neoangiogenesis) may not correspond to areas of increased glycolysis, highlighting the potential complementary role of these radiotracers in MM evaluation.http://www.sciencedirect.com/science/article/pii/S2531137925000719Multiple MyelomaPET/CTSUV Quantification¹⁸F-FDG⁶⁸Ga-PSMA |
| spellingShingle | Alexandre Mercuri Barbosa Maria Emília Seren Takahashi Stephan Pinheiro Macedo Souza Edna Marina Souza Sérgio Querino Brunetto Cármino Antonio de Souza Irene Gyongyver Heidemarie Lorand-Metze Celso Darío Ramos CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT Hematology, Transfusion and Cell Therapy Multiple Myeloma PET/CT SUV Quantification ¹⁸F-FDG ⁶⁸Ga-PSMA |
| title | CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT |
| title_full | CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT |
| title_fullStr | CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT |
| title_full_unstemmed | CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT |
| title_short | CT-SEGMENTED BONE SUV IN MULTIPLE MYELOMA: A COMPARATIVE STUDY OF ¹⁸F-FDG AND ⁶⁸GA-PSMA PET/CT |
| title_sort | ct segmented bone suv in multiple myeloma a comparative study of ¹⁸f fdg and ⁶⁸ga psma pet ct |
| topic | Multiple Myeloma PET/CT SUV Quantification ¹⁸F-FDG ⁶⁸Ga-PSMA |
| url | http://www.sciencedirect.com/science/article/pii/S2531137925000719 |
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