18F-fluorodesoxyglucose positron emission tomography/computed tomography in extramedullary multiple myeloma

Background: 18F-fluorodesoxyglucose positron emission tomography/ computed tomography (PET-CT) has a high sensitivity and specificity to detect medullary and extramedullary lesions in multiple myeloma (MM).

Objective: To describe the findings of PET-CT in extramedullary multiple myeloma (EMM) at diagnosis and at relapse, and correlate its results with clinical variables, response to treatment and survival.

Methods: Review of medical records and PET-CT reports of 39 patients with multiple myeloma (MM) who had at least one PET-CT study, treated between January 1, 2015, and January 1, 2019 at a clinical hospital.

Results: The Standard Uptake Values for each hypermetabolic lesion were not described in PET-CT reports. Fifteen patients had an EMM and in eight, without a previous clinical suspicion, PET-TC lead to the diagnosis. The mortality rate in the 39 patients with MM was 46%. Sixty seven percent of deaths occurred in patients with EMM.

Conclusions: PET-TC was useful to diagnose EMM. However, a standardization in PETCT reports would be required to unify criteria. As previously reported, EMM had a greater aggressiveness and lower survival.