International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 021-028
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PET-CT Guided Adipose Tissue Indices as Prognostic Factors in Multiple Myeloma
Demircan OZBALCI1, Mehmet ERDOGAN2, Emine GUCHAN ALANOGLU1, Sevim Sureyya SENGUL2, Burcu BACAK3, Hande Nur EROGLU4, Ismail OZKOC2
1Suleyman Demirel University Faculty of Medicine, Department of Hematology
2Suleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine
3State Hospital of Kumluca, Department of Internal Medicine
4Isparta Provincial Health Directorate, Department of Public Health
Keywords: Multiple myeloma, Subcutaneous adipose tissue, Total abdominal adipose tissue, Radiodensity, 18F-FDG PET/CT
This study evaluated the prognostic impact of obesity in multiple myeloma with 18F-FDG PET/CT guided measurement of total ab- dominal adipose tissue (TAAT) radiodensity, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) glucose uptake. Three hundred and eight patients who have been diagnosed with multiple myeloma and received chemotherapy in our hospital from 2011 to 2021 were retrospectively evaluated. 18F-FDG PET/CT scans at diagnosis were used to calculate TAAT, VAT and SAT maxi- mum standardized uptake value (SUVmax) and these values were evaluated for their effect on adverse prognostic factors, progres- sion free (PFS) and overall survival (OS). After being evaluated for exclusion criteria, 94 patients were included for the study. Adipose tissue volume greater than 6658 cc, TAAT radiodensity less than -97 Hounsfield units (HU), and SAT SUVmax of 0.3 or lower were associated with significantly increased the OS (p= 0.040, p< 0.001 and p< 0.001, respectively). Each step of worsening of response to treatment, no transplantation, SAT SUVmax more than 0.3 were associated with reduced PFS in patients with myeloma (p= 0.004, p= 0.001 and p= 0.005 respectively). Similarly, each step of worsening response to treatment, total protein greater than 6.6 mg/dl, each increase in stage, no transplantation, TAAT radiodensity more than -97 HU were associated with significantly reduced OS (p= 0.003, p= 0.009, p< 0.001, p= 0.028 and p< 0.001 respectively). SAT SUVmax and TAAT radiodensity are two independent prognostic marker that influences PFS and OS respectively.
Demircan OZBALCI1, Mehmet ERDOGAN2, Emine GUCHAN ALANOGLU1, Sevim Sureyya SENGUL2, Burcu BACAK3, Hande Nur EROGLU4, Ismail OZKOC2
1Suleyman Demirel University Faculty of Medicine, Department of Hematology
2Suleyman Demirel University Faculty of Medicine, Department of Nuclear Medicine
3State Hospital of Kumluca, Department of Internal Medicine
4Isparta Provincial Health Directorate, Department of Public Health
Keywords: Multiple myeloma, Subcutaneous adipose tissue, Total abdominal adipose tissue, Radiodensity, 18F-FDG PET/CT
This study evaluated the prognostic impact of obesity in multiple myeloma with 18F-FDG PET/CT guided measurement of total ab- dominal adipose tissue (TAAT) radiodensity, subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) glucose uptake. Three hundred and eight patients who have been diagnosed with multiple myeloma and received chemotherapy in our hospital from 2011 to 2021 were retrospectively evaluated. 18F-FDG PET/CT scans at diagnosis were used to calculate TAAT, VAT and SAT maxi- mum standardized uptake value (SUVmax) and these values were evaluated for their effect on adverse prognostic factors, progres- sion free (PFS) and overall survival (OS). After being evaluated for exclusion criteria, 94 patients were included for the study. Adipose tissue volume greater than 6658 cc, TAAT radiodensity less than -97 Hounsfield units (HU), and SAT SUVmax of 0.3 or lower were associated with significantly increased the OS (p= 0.040, p< 0.001 and p< 0.001, respectively). Each step of worsening of response to treatment, no transplantation, SAT SUVmax more than 0.3 were associated with reduced PFS in patients with myeloma (p= 0.004, p= 0.001 and p= 0.005 respectively). Similarly, each step of worsening response to treatment, total protein greater than 6.6 mg/dl, each increase in stage, no transplantation, TAAT radiodensity more than -97 HU were associated with significantly reduced OS (p= 0.003, p= 0.009, p< 0.001, p= 0.028 and p< 0.001 respectively). SAT SUVmax and TAAT radiodensity are two independent prognostic marker that influences PFS and OS respectively.
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