Potential Role for 18F-FDG PET Scan Evaluation Based on Current Data
| Suspected disease status | Clinical question | Potential role of 18F-FDG PET |
|---|---|---|
| MGUS* | How likely is progression? | If 18F-FDG PET results are negative, stable MGUS is likely |
| Active myeloma* | Is disease smoldering or active? | If 18F-FDG PET results are positive, active disease is likely, even if radiography results are negative |
| What is prognosis? | Extramedullary disease indicates poor prognosis | |
| Remission | Is there true complete remission? | Positive scan findings after transplantation indicate persistent disease or relapse and poorer outcome |
| Is there new disease? | New focal disease (especially nonsecretory) can be documented and treated | |
| Relapse | Is there unsuspected new disease? | Can detect clinically important disease requiring unanticipated therapy (e.g., ureteral obstruction) |
| What is baseline restaging at relapse? | Can establish baseline for ongoing monitoring in clinical trials |
↵* Working definitions for MGUS vs. active myeloma are currently under review by International Prognostic Index Study Group. It is possible that 18F-FDG PET scanning can contribute to diagnostic or discriminatory criteria.