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@ARTICLE{Sachpekidis:132856,
      author       = {C. Sachpekidis$^*$ and H. Goldschmidt$^*$ and K. Kopka$^*$
                      and A. Kopp-Schneider$^*$ and A.
                      Dimitrakopoulou-Strauss$^*$},
      title        = {{A}ssessment of glucose metabolism and cellular
                      proliferation in multiple myeloma: a first report on
                      combined 18{F}-{FDG} and 18{F}-{FLT} {PET}/{CT} imaging.},
      journal      = {EJNMMI Research},
      volume       = {8},
      number       = {1},
      issn         = {2191-219X},
      address      = {Berlin},
      publisher    = {Springer},
      reportid     = {DKFZ-2018-00499},
      pages        = {28},
      year         = {2018},
      abstract     = {Despite the significant upgrading in recent years of the
                      role of 18F-FDG PET/CT in multiple myeloma (MM) diagnostics,
                      there is a still unmet need for myeloma-specific
                      radiotracers. 3-Deoxy-3-[18F]fluorothymidine (18F-FLT) is
                      the most studied cellular proliferation PET agent,
                      considered a potentially new myeloma functional imaging
                      tracer. The aim of this pilot study was to evaluate 18F-FLT
                      PET/CT in imaging of MM patients, in the context of its
                      combined use with 18F-FDG PET/CT.Eight patients, four
                      suffering from symptomatic MM and four suffering from
                      smoldering MM (SMM), were enrolled in the study. All
                      patients underwent 18F-FDG PET/CT and 18F-FLT PET/CT imaging
                      by means of static (whole body) and dynamic PET/CT of the
                      lower abdomen and pelvis (dPET/CT) in two consecutive days.
                      The evaluation of PET/CT studies was based on qualitative
                      evaluation, semi-quantitative (SUV) calculation, and
                      quantitative analysis based on two-tissue compartment
                      modeling. 18F-FDG PET/CT demonstrated focal, 18F-FDG avid,
                      MM-indicative bone marrow lesions in five patients. In
                      contrary, 18F-FLT PET/CT showed focal, 18F-FLT avid,
                      myeloma-indicative lesions in only two patients. In total,
                      48 18F-FDG avid, focal, MM-indicative lesions were detected
                      with 18F-FDG PET/CT, while 17 18F-FLT avid, focal,
                      MM-indicative lesions were detected with 18F-FLT PET/CT. The
                      number of myeloma-indicative lesions was significantly
                      higher for 18F-FDG PET/CT than for 18F-FLT PET/CT. A common
                      finding was a mismatch of focally increased 18F-FDG uptake
                      and reduced 18F-FLT uptake (lower than the surrounding bone
                      marrow). Moreover, 18F-FLT PET/CT was characterized by high
                      background activity in the bone marrow compartment, further
                      complicating the evaluation of bone marrow lesions.
                      Semi-quantitative evaluation revealed that both SUVmean and
                      SUVmax were significantly higher for 18F-FLT than for
                      18F-FDG in both MM lesions and reference tissue. SUV values
                      were higher in MM lesions than in reference bone marrow for
                      both tracers.Despite the limited number of patients analyzed
                      in this pilot study, the first results of the trial indicate
                      that 18F-FLT does not seem suitable as a single tracer in MM
                      diagnostics. Further studies with a larger patient
                      population are warranted to generalize the herein presented
                      results.},
      cin          = {E060 / E030 / L101 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E060-20160331 / I:(DE-He78)E030-20160331 /
                      I:(DE-He78)L101-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29633046},
      pmc          = {pmc:PMC5891438},
      doi          = {10.1186/s13550-018-0383-7},
      url          = {https://inrepo02.dkfz.de/record/132856},
}