[11C]-Methionine PET/CT in evaluation of bone marrow infiltration and usage as a prognostic tool in multiple myeloma


ÖZKAN E., Demir B., CENGİZ SEVAL G., ARAZ M., SOYDAL Ç., Mesci I., ...Daha Fazla

Annals of Nuclear Medicine, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1007/s12149-026-02180-6
  • Dergi Adı: Annals of Nuclear Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Anahtar Kelimeler: Hematology, Molecular Imaging, Multiple Myeloma, Oncology, Positron Emission Tomography, [11C]-Methionine PET/CT
  • Ankara Üniversitesi Adresli: Evet

Özet

Purpose: To evaluate the prognostic utility of a novel quantitative imaging metric, whole-body metabolic burden (WB-MB), derived from [11C]-Methionine PET/CT, in patients with multiple myeloma (MM), and to assess its correlation with clinical biomarkers and survival outcomes. Methods: In this prospective, single-center study, 34 patients with biopsy-confirmed MM underwent whole-body [11C]-Methionine PET/CT for staging or restaging. WB-MB was calculated using a semi-quantitative method incorporating both the extent and intensity of methionine uptake across 12 anatomical regions. Liver- and aorta-normalized WB-MB ratios (WB-MB/liver and WB-MB/aorta) were also computed. Correlations with laboratory biomarkers were analyzed using regression models, and prognostic performance was assessed through Kaplan-Meier survival analysis and hazard ratios for progression-free survival (PFS) and overall survival (OS). Results: WB-MB showed significant inverse correlation with hemoglobin and positive correlations with LDH, beta-2 microglobulin (B2M), and serum kappa free light chain levels. No significant associations were observed with platelet count, WBC, or lambda light chains. WB-MB, WB-MB/liver, and WB-MB/aorta were all significantly associated with OS and PFS (p < 0.05), while maximum SUVmean was not. A WB-MB threshold of 164.79 was identified as predictive for PFS. Notably, no deaths occurred in patients with WB-MB < 101 during follow-up. Conclusion: WB-MB scoring with [11C]-Methionine PET/CT is a promising, reproducible imaging biomarker for evaluating disease burden and prognosis in MM. It correlates with key laboratory markers and outperforms static SUV-based metrics in predicting survival outcomes. Further multicenter studies are needed to validate these findings and explore integration into therapeutic decision-making.