RT Journal Article
SR Electronic
T1 Hexokinase-2 Expression in <sup>11</sup>C-Methionine–Positive, <sup>18</sup>F-FDG–Negative Multiple Myeloma
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 348
OP 352
DO 10.2967/jnumed.118.217539
VO 60
IS 3
A1 Kircher, Stefan
A1 Stolzenburg, Antje
A1 Kortüm, Klaus Martin
A1 Kircher, Malte
A1 Da Via, Matteo
A1 Samnick, Samuel
A1 Buck, Andreas K.
A1 Einsele, Hermann
A1 Rosenwald, Andreas
A1 Lapa, Constantin
YR 2019
UL http://jnm.snmjournals.org/content/60/3/348.abstract
AB PET with 18F-FDG is the standard modality in nuclear medicine for imaging multiple myeloma (MM). However, viable MM as detected by MRI or PET with other metabolic tracers, including 11C-methionine, may be missed—for example, because of low hexokinase 2 (HK2) expression of tumor cells. The aim of this study was to further investigate potential reasons for PET false negativity. Methods: A cohort of 15 mainly pretreated patients with relapsed or refractory biopsy-proven, serologically active MM who underwent both 18F-FDG and 11C-methionine PET/CT was retrospectively analyzed. Results: In 9 of the 15 patients, 18F-FDG PET was negative in the presence of viable disease. In the remaining 6 patients, both 18F-FDG and 11C-methionine PET/CT revealed the same number of MM lesions. At immunohistochemistry, 18F-FDG–negative myeloma did not exhibit significant differences in HK2 or glucose-6-phosphatase expression from 18F-FDG–positive disease (P = 0.57 and P = 0.44, respectively). Conclusion: Beyond HK2 expression, 18F-FDG negativity in (mainly pretreated) MM patients seems to be associated with additional causes not yet known.