The Clinical Application Of ¹⁸F-FDG PET/CT In The Diagnosis And Prognosis Evaluation Of Multiple Myeloma

[Objective]1.Retrospectively analyze features of 18F-FDG PET/CT images of patients with multiple myeloma, and discuss the value of it in diagnosis and staging.2. Analyze the relationship between the osteopathy SUVmax of 18F-FDG PET/CT images and data of the clinical and pathological of multiple myeloma patients,and also the prognosis.[Method]Retrospectively analyze the data of including the clinical and pathology results of 105 patients with multiple myeloma from March 2009 to 2015 August in the hospital who underwent 18F-FDG PET/CT.Analyze features and diagnostic efficiency of PET/CT images, and PET/CT Durie salmon (DS) plus staging and clinical ISS staging results were under kappa consistency test. Correlation between osteopathy SUVmax and clinical data,pathological data was analyzed using Wilcoxon rank sum test. Bring osteopathy SUVmax, clinical data, pathological data into the Spearman correlation analysis. Bring osteopathy SUVmax,clinical data, pathological data into univariate analysis using Kaplan Meier survival analysis, and survival rate between groups were analyzed using the log rank test. Factors influence the survival of multiple myeloma patient were analyzed using Cox’s proportional hazards regression model to have multivariate analysis.[Results]1.In 105 patients,101 patients had different degrees of bone destruction,3 cases for generalized osteoporosis, only 1 patients without obvious bone destruction.11 cases were accompanied with extramedullary plasmacytoma lesions, and all were soft tissue lesions.1 case was false positive; the sensitivity, accuracy and positive predictive value of 18F-FDG PET/CT imaging of the diagnosis of multiple myeloma was 88.6%,88.6% and 92.1% respectively. DS plus stage of 105 cases were:17 cases of stage □,39 cases of stage Ⅱ,49 cases of stage III; Compared with clinical ISS stage using consistency test, the Kappa value is 0.703, P is 0.000.2.Compare different osteopathy SUVmax of the number of lesions, DS plus staging, ISS staging, serum albumin and (32 microspheres protein content between groups of multiple myeloma patients, and the difference was statistical significance; and different osteopathy SUVmax of gender, age and extramedullary lesions, hemoglobin, globulin, C reactive protein, lactic dehydrogenase, serum calcium, bone marrow monoclonal plasma cell ratio and serum creatinine level between groups of multiple myeloma patients, the difference was not statistically significant. Correlation between osteopathy SUVmax and lesion number,with or without extramedullary lesions, DS plus stage, ISS stage, hemoglobin, albumin and β2 microspheres was confirmed, while the correlation between the osteopathy SUVmax and hemoglobin,albumin content is negative,and osteopathy SUVmax had no relation with gender, age, globulin, C reactive protein, lactic dehydrogenase, serum calcium, bone marrow monoclonal plasma cell proportion and serum creatinine level.3.To the deadline of follow-up,2 patients were lost,93 patients died. The median survival time was 44.4 months. Single factor analysis showed that the number of lesions, osteopathy SUVmax, with or without extramedullary lesions, DS plus stage, hemoglobin, albumin, ISS staging and β2 microglobulin content were prognosis factors in patients of newly diagnosed of multiple myeloma. While gender, age, globulin, C reactive protein, lactic dehydrogenase, serum calcium, bone marrow monoclonal plasma cell percentage and serum creatinine level were not correlated with the prognosis.Cox regression multivariate analysis showed that osteopathy SUVmax, with or without extramedullary lesions, DS plus stage were independent prognostic factors of newly diagnosed multiple myeloma patients. Number of lesions, hemoglobin, albumin, ISS staging and β2 microglobulin content were non-indpendent prognostic factors for multivariate regression analysis, and there were no significant difference.【Conclusion】1,18F-FDG PET/CT whole-body imaging of multiple myeloma had certain characteristics, lesion detection rate of intramedullary and extramedullary plasmacytoma were high. DS plus staging according to 18F-FDG PET/CT diagnostic criteria and clinical ISS staging had highly consistency. Therefore, PET/CT imaging can be used as effective inspection method in diagnosis and staging of multiple myeloma.2.Different number of the lesions, DS plus staging,ISS staging, serum albumin and (32 microspheres protein content had different osteopathy SUVmax. Osteopathy SUVmax was increased as extramedullary lesions,the number of lesions, DS plus stage, ISS stage and P2 microglobulin content increased. On the other hand, osteopathy SUVmax decreased as the hemoglobin and serum albumin content increased.3.Number of lesions, osteopathy SUVmax, with or without extramedullary lesions, DS plus stage, hemoglobin, albumin, ISS stage and 02 microglobulin content were all prognosis related factors of patients who were newly diagnosed multiple myeloma, and osteopathy SUVmax, with or without extramedullary lesions, DS plus stage were independent prognostic factors of newly diagnosed multiple myeloma patients.