TY - JOUR T1 - <sup>11</sup>C-Acetate PET/CT for Metabolic Characterization of Multiple Myeloma: A Comparative Study with <sup>18</sup>F-FDG PET/CT JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 749 LP - 752 DO - 10.2967/jnumed.113.131169 VL - 55 IS - 5 AU - Chi-lai Ho AU - Sirong Chen AU - Yim Lung Leung AU - Thomas Cheng AU - Ka-nin Wong AU - Shing Kee Cheung AU - Raymond Liang AU - Chor Sang Chim Y1 - 2014/05/01 UR - http://jnm.snmjournals.org/content/55/5/749.abstract N2 - We prospectively compared 11C-acetate with 18F-FDG in a PET/CT evaluation of multiple myeloma (MM), specifically on diagnostic accuracy, identification of high-risk patients, and monitoring of treatment response. Methods: Dual-tracer PET/CT was performed on 35 pathologically and clinically confirmed and untreated patients (26 with symptomatic MM, 5 with smoldering MM, and 4 with monoclonal gammopathy of unknown significance) and 20 individuals with normal marrow. Results: 11C-acetate showed significant incremental value over 18F-FDG (84.6% vs. 57.7%) for positively identifying patients with diffuse and focal symptomatic MM, and was negative in patients with indolent smoldering MM and monoclonal gammopathy of unknown significance. Three functional parameters—number of 11C-acetate–avid and 18F-FDG–avid focal bone lesions and 11C-acetate general marrow activity—strongly correlated with β-2-microglobulin as surrogate imaging markers of tumor burden. After induction chemotherapy, the metabolic change in 11C-acetate general marrow activity correlated with clinical response. Conclusion: Metabolic characterization of MM in diagnosis, risk stratification, and treatment monitoring can be done more accurately by assessing lipid metabolism with 11C-acetate than by assessing glucose metabolism with 18F-FDG. ER -