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@ARTICLE{Sachpekidis:176937,
      author       = {C. Sachpekidis$^*$ and M. Merz and M.-S. Raab$^*$ and U.
                      Bertsch and V. Weru$^*$ and A. Kopp-Schneider$^*$ and A.
                      Jauch and H. Goldschmidt and A. Dimitrakopoulou-Strauss$^*$},
      title        = {{T}he prognostic significance of [18{F}]{FDG} {PET}/{CT} in
                      multiple myeloma according to novel interpretation criteria
                      ({IMP}e{TU}s).},
      journal      = {EJNMMI Research},
      volume       = {11},
      number       = {1},
      issn         = {2191-219X},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2021-02177},
      pages        = {100},
      year         = {2021},
      note         = {#EA:E060#LA:E060#},
      abstract     = {[18F]FDG PET/CT is the elective imaging modality for
                      treatment monitoring in multiple myeloma (MM). However, MM
                      is a heterogeneous disease from an imaging point of view,
                      raising challenges in interpretation of PET/CT. We herein
                      investigated the prognostic role of the novel Italian
                      Myeloma criteria for PET Use (IMPeTUs) in MM patients
                      undergoing high-dose chemotherapy (HDT) followed by
                      autologous stem cell transplantation (ASCT).Forty-seven
                      patients with newly diagnosed MM underwent [18F]FDG PET/CT
                      before commencement of treatment (baseline PET/CT).
                      Thirty-four of them $(72.3\%)$ were also examined after
                      completion of ASCT (follow-up PET/CT). PET/CT analysis was
                      based on the IMPeTUs criteria, which take into
                      consideration-among others-the metabolic state of the bone
                      marrow based on the 5-point Deauville score (DS), the number
                      and metabolic state of focal [18F]FDG-avid lesions, as well
                      as the presence of paramedullary disease (PMD) and
                      extramedullary disease (EMD). We analyzed whether parameters
                      from IMPeTUs correlate with clinically relevant parameters
                      and patients' outcome, as assessed by progression-free
                      survival (PFS).Median follow-up from baseline and follow-up
                      PET/CT were 85.1 months and 76.7 months, respectively. The
                      number of focal, [18F]FDG-avid lesions significantly
                      correlated with the bone marrow infiltration rate and the
                      R-ISS stage, while the presence of PMD was associated with
                      LDH. After univariate survival analysis, the number of
                      focal, [18F]FDG-avid lesions both before and after therapy
                      as well as the presence of PMD and EMD before therapy
                      adversely affected PFS. Multivariate survival analysis for
                      baseline parameters confirmed that the number of focal,
                      [18F]FDG-avid lesions and the presence of EMD are associated
                      with adverse prognosis, irrespective of the ISS stage and/or
                      the presence of high-risk cytogenetic abnormalities. The
                      5-point DS of [18F]FDG uptake in reference bone marrow and
                      focal lesions showed a significant decrease as response to
                      treatment, but it did not affect PFS.Several parameters
                      utilized in IMPeTUs predict PFS in MM patients, suggesting
                      the potentially significant role of the new criteria in
                      patient stratification and response assessment. Additional
                      studies are warranted for the further evaluation of IMPeTUs
                      in the direction of establishment of robust cut-off values
                      with a prognostic significance in the disease.},
      keywords     = {Interpretation criteria (Other) / Italian Myeloma criteria
                      for PET Use (IMPeTUs) (Other) / Multiple myeloma (Other) /
                      [18F]FDG PET/CT (Other)},
      cin          = {E060 / A360 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E060-20160331 / I:(DE-He78)A360-20160331 /
                      I:(DE-He78)C060-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34628525},
      doi          = {10.1186/s13550-021-00846-y},
      url          = {https://inrepo02.dkfz.de/record/176937},
}