The following is a summary of “Coefficient of variation and texture analysis of 18F-FDG PET/CT images for the prediction of outcome in patients with multiple myeloma,” published in the July 2024 issue of Hematology by Pellegrino et al.

Multiple myeloma (MM) is characterized by unpredictable bone marrow infiltration, complicating staging and prognosis.

Researchers conducted a retrospective study by assessing 18 F-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) image texture analysis to predict survival in patients with MM.

They assessed 46 patients using 18F-FDG-PET/CT prior to the treatment. An automated contouring program was applied to segment the hottest focal lesion (FL) and a lumbar vertebra to evaluate diffuse bone marrow involvement (DI). The maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and texture features like the coefficient of variation (CoV) were obtained from both 46 FL and 46 DI.

The results showed that after a mean follow-up of 51 months, 24 of 46 patients with MM died, compared to 22 survivors. Univariate analysis indicated that FL SUVmax (P=0.0453), FL SUVmean (P=0.0463), FLCoV (P=0.0211), and DI SUVmax (P=0.0538) predicted OS. Multivariate analysis retained only FL CoV and DI SUVmax in the model (P=0.0154). Kaplan-Meier and log-rank tests revealed that patients with FL CoV below the cut-off had significantly better OS (P=0.0003), and with DI SUVmax below the threshold had better OS (P=0.0006). Combining FL CoV and DI SUVmax using the cut-off values demonstrated a significant difference among the 4 survival curves (P=0.0001), with the best prognosis observed in patients having both FL CoV and DI SUVmax below their respective cut-off values.

Investigators concluded that 18F-FDG PET/CT analysis, including conventional and texture parameters, can predict survival in patients with MM obtained by assessing tumor heterogeneity and aggressiveness.

Source: link.springer.com/article/10.1007/s00277-024-05905-7