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PET/CT Scans- Myeloma Prognosis

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PET/CT scans allow you to see inside your bone marrow. Multiple myeloma is a cancer of the plasma cells. Plasma cells that multiply uncontrollably in a person’s bone marrow. In order to

  • diagnose,
  • stage,
  • treat,
  • monitor,
  • etc.

the patient’s plasma cells, you need to see inside a person’s bone marrow. This is a challenge to say the least.

What is the value of PET/CT scans in multiple myeloma?

Positron emission tomography/computed tomography (PET/CT) scans play a valuable role in the management of multiple myeloma, a type of cancer that affects plasma cells in the bone marrow. Here are some key aspects of the value of PET/CT scans in multiple myeloma:

  1. Disease Staging: PET/CT scans are useful for staging multiple myeloma, helping to determine the extent and spread of the disease. They can identify areas of active bone disease, soft tissue involvement, and detect any extramedullary lesions.
  2. Assessment of Treatment Response: PET/CT scans are employed to assess the response to treatment in multiple myeloma patients. The scans can help evaluate changes in metabolic activity and identify areas of residual disease. This information is crucial for making informed decisions about ongoing treatment strategies.
  3. Monitoring Disease Progression: Serial PET/CT scans over time can provide a dynamic assessment of disease progression or regression. This helps in adapting treatment plans as needed based on the evolving nature of the disease.
  4. Detection of Extramedullary Disease: Multiple myeloma can sometimes involve tissues outside the bone marrow, forming extramedullary lesions. PET/CT scans are sensitive in detecting these lesions, which may have implications for treatment planning and prognosis.
  5. Identification of High-Risk Patients: PET/CT findings, such as the presence of focal lesions or high metabolic activity, can help identify patients at higher risk for disease progression. This information is valuable for tailoring treatment approaches and intensifying therapy for those at higher risk.
  6. Bone Disease Assessment: PET/CT scans can provide detailed information about the extent and activity of bone lesions associated with multiple myeloma. This is important for evaluating the impact of the disease on the skeletal system and guiding interventions to manage bone-related complications.

According to the study linked and excerpted below, PET/CT scans are adept at assessing the patient’s plasma cells after he/she  has undergone induction therapy to see how the patient’s has responded to treatment.
When I was first diagnosed with myeloma, PET/CT scanning hadn’t yet been developed for the type of prognostic value that is discussed in the research below. As a result I underwent both chemo and radiation without having the benefit of prognostic value of my treatments.
Meaning, I underwent a lot of toxicity yet my oncologists didn’t really know if I was responding or not. It turns out that I didn’t really respond to conventional therapies…
Have you been diagnosed with multiple myeloma? What are your symptoms? What is your stage? Let me know-
David Emerson
  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Utility of PET/CT in Assessing Early Treatment Response in Patients With Newly Diagnosed Multiple Myeloma

“Multiple Myeloma (MM) is a plasma cell malignancy characterized by diverse clinical presentations. While biochemical assessment of disease activity is commonly utilized to monitor treatment response, findings on magnetic resonance imaging and positron emission tomography/computed tomography (PET/CT), among other imaging modalities, have proven to harbor prognostic value.

We sought to corroborate these findings by examining the prognostic significance of Fluorodeoxyglucose (FDG) PET/CT scanning in the setting of newly diagnosed MM.

We retrospectively analyzed 195 patients with a PET/CT available both

  • at diagnosis and
  • at 6 months post-treatment

to examine the value of PET/CT results as an adjuvant metric to conventional hematologic responses in terms of time to next treatment (TTNT) and overall survival (OS).

The median TTNT and OS for the entire cohort were 24.6  and 79  months, respectively.

When comparing PET/CT (-) with PET/CT (+) patients, we found significantly prolonged median TTNT (55.2 vs. 17.8 months, p<0.0001) and OS (unreached vs. 60.8 months, p<0.0001) for the PET/CT (-) group.

We then examined the additive value of PET/CT on the hematologic response achieved at 6 months, and we found that PET/CT (-) is associated with significantly increased median TTNT and OS for both the very good partial response (VGPR) group and the less than VGPR group.

Importantly, PET/CT retained prognostic significance after adjusting for multiple other predictive variables.

We conclude that a PET/CT (-) at 6 months confers a significant prognostic advantage for newly diagnosed MM patients and adds significant value to the hematologic response assessment.”

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