Open AccessPF613 CLINICAL UTILITY OF [18F]FLORBETABEN PET/CT SCAN FOR IMAGING AMYLOIDOSIS IN MULTIPLE MYELOMA PATIENTS
Author(s) -
Jo J.C.,
Seo M.,
Choi Y.S.,
Lee Y.J.,
Park S.H.,
Cha H.J.,
Park S.H.
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000560740.23483.6d
Subject(s) - amyloidosis , medicine , amyloid (mycology) , multiple myeloma , nuclear medicine , positron emission tomography , al amyloidosis , pet ct , standardized uptake value , pathology , radiology , immunoglobulin light chain , antibody , immunology
Background: [ 18 F]Florbetaben is a positron emission tomography (PET) tracer that specifically binds to amyloid beta‐pleated structure. Diagnosis of immunoglobulin light‐chain amyloidosis in patients with multiple myeloma (MM) is clinically important to manage symptoms and signs associated with amlyoidosis. Aims: We aimed to evaluate the feasibility of [ 18 F]Florbetaben PET for detecting amyloid deposits in MM patients and to explore the most optimal method for PET analysis. Methods: Fourteen patients with multiple myeloma were prospectively enrolled (6 patients with amyloidosis and 8 controls) between Aug 2018 and Nov 2018. After injection of 300 MBq of [ 18 F]Florbetaben, dynamic imaging of the kidneys was acquired for 20 minutes. Time‐activity curve was generated by using a region of interest placed over the kidney and retention index (RI) was obtained. At 90 minutes post‐injection, PET image was acquired, with a scan field from the vertex to mid‐thigh. All images were assessed both qualitatively and quantitatively. Comparison between amyloidosis and non‐amyloidosis groups was performed, regarding SUVmax, SUVmean, and SUV ratio (SUVR = tissue of interest/reference region), which were obtained from both sphere and manually drawn volumes of interest (VOI). Amyloid deposition was confirmed according to international consensus guidelines. Results: All patients in the control group did not show any abnormal amyloid uptake on 18F‐Florbetaben PET/CT (0/8), while those in the amyloid group had amyloid positive findings in more than one organ (6/6, 100%). Among 15 organs confirmed to have amyloidosis involvement prior to PET/CT, 9 were positive on 18F‐Florbetaben PET/CT. The detection rates of amyloidosis involvement in the heart, stomach, and tongue were excellent (100%), whereas those of the liver, esophagus, and colon were poor. 18F‐Florbetaben PET/CT found 12 unexpected abnormal amyloid uptakes in the tongue, thyroid, heart, lung, stomach, and spleen. Three of these 12 unexpected uptakes were later clinically determined to be amyloidosis (1 tongue, 1 heart, and 1 lung). Summary/Conclusion: [ 18 F]Florbetaben PET can be one of the tool to detect systemic amyloid deposits in MM patients, especially in the heart, stomach, and tongue.