https://www.theragnostics.no/en/author/syed-nuruddin/ Syed Nuruddin Hugo Blox Builder (https://hugoblox.com)en-usSat, 01 Oct 2022 00:00:00 +0000 https://www.theragnostics.no/media/icon_hu14557955862192370321.png https://www.theragnostics.no/en/author/syed-nuruddin/ https://www.theragnostics.no/en/publications/stokke-2022-comparison/ Sat, 01 Oct 2022 00:00:00 +0000 https://www.theragnostics.no/en/publications/stokke-2022-comparison/ <hr> <p>[¹⁸F]FDG PET/CT in multiple myeloma (MM) is currently the best technology to demonstrate patchy and extramedullary disease. However, [¹⁸F]FDG PET has some limitations, and imaging with alternative tracers should be explored. In this study, we aimed to evaluate the performance of [¹⁸F]fluciclovine PET compared to [¹⁸F]FDG PET in newly diagnosed MM patients. Thirteen newly diagnosed transplant eligible MM patients were imaged both with [¹⁸F]FDG PET/CT and [¹⁸F]fluciclovine PET/CT within 1 week in a prospective study. The subjects were visually assessed positive or negative for disease. The number of lesions and the SUV_max of selected lesions were measured for both tracers. Furthermore, tracer uptake ratios were obtained by dividing lesion SUV_max by blood or bone marrow SUV_max. Between-group differences and correlations were assessed with paired t-tests and Pearson tests. Bone marrow SUVs were compared to bone marrow plasma cell percentage in biopsy samples. Nine subjects were assessed positively by [¹⁸F]FDG PET (69%) and 12 positives by [¹⁸F]fluciclovine PET (92%). All positive subjects had [¹⁸F]fluciclovine scans that were qualitatively scored as easier to interpret visually than the [¹⁸F]FDG scans. The number of lesions was also higher; seven of nine subjects with distinct hot spots on [¹⁸F]fluciclovine PET had fewer or no visible lesions on [¹⁸F]FDG PET. The mean lesion SUV_max values were 8.2 and 3.8 for [¹⁸F]fluciclovine and [¹⁸F]FDG, respectively. The mean tumour to blood values were 6.4 and 2.0 for [¹⁸F]fluciclovine and [¹⁸F]FDG, and the mean ratios between tumour and bone marrow were 2.1 and 1.5 for [¹⁸F]fluciclovine and [¹⁸F]FDG. The lesion SUV_max and ratios were significantly higher for [¹⁸F]fluciclovine (all p &lt; 0.01). Local [¹⁸F]fluciclovine SUV_max or SUV_mean values in os ilium and the percentage of plasma cells in bone marrow biopsies were linearly correlated (p = 0.048). There were no significant correlations between [¹⁸F]FDG SUVs and plasma cells (p = 0.82). Based on this pilot study, [¹⁸F]fluciclovine is a promising tracer for MM. The visual and semi-quantitative evaluations indicate that [¹⁸F]fluciclovine PET/CT can out-perform [¹⁸F]FDG PET/CT at diagnosis.</p>