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Review

Functional Imaging for Therapeutic Assessment and Minimal Residual Disease Detection in Multiple Myeloma

1
Nuclear Medicine/Hematology Department, Nantes University Hospital, F-44000 Nantes, France
2
Seràgnoli Institute of Hematology, Bologna University School of Medicine, 40126 Bologna, Italy
3
Nuclear Medicine Department, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
4
CHU de Nantes, CNRS, Inserm, CRCINA, Université de Nantes, F-44000 Nantes, France
5
Nuclear Medicine Department, ICO René Gauducheau, F-44800 Saint-Herblain, France
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(15), 5406; https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21155406
Received: 27 May 2020 / Revised: 25 July 2020 / Accepted: 28 July 2020 / Published: 29 July 2020
Serum markers and bone marrow examination are commonly used for monitoring therapy response in multiple myeloma (MM), but this fails to identify minimal residual disease (MRD), which frequently persists after therapy even in complete response patients, and extra-medullary disease escape. Positron emission tomography with computed tomography using 18F-deoxyglucose (FDG-PET/CT) is the reference imaging technique for therapeutic assessment and MRD detection in MM. To date, all large prospective cohort studies of transplant-eligible newly diagnosed MM patients have shown a strong and independent pejorative prognostic impact of not obtaining complete metabolic response by FDG-PET/CT after therapy, especially before maintenance. The FDG-PET/CT and MRD (evaluated by flow cytometry or next-generation sequencing at 10−5 and 10−6 levels, respectively) results are complementary for MRD detection outside and inside the bone marrow. For patients with at least a complete response, to reach double negativity (FDG-PET/CT and MRD) is a predictive surrogate for patient outcome. Homogenization of FDG-PET/CT interpretation after therapy, especially clarification of complete metabolic response definition, is currently underway. FDG-PET/CT does not allow MRD to be evaluated when it is negative at initial workup of symptomatic MM. New PET tracers such as CXCR4 ligands have shown high diagnostic value and could replace FDG in this setting. New sensitive functional magnetic resonance imaging (MRI) techniques such as diffusion-weighted MRI appear to be complementary to FDG-PET/CT for imaging MRD detection. The goal of this review is to examine the feasibility of functional imaging, especially FDG-PET/CT, for therapeutic assessment and MRD detection in MM. View Full-Text
Keywords: MM; imaging; therapeutic assessment; FDG-PET/CT; prognostic value; MRD MM; imaging; therapeutic assessment; FDG-PET/CT; prognostic value; MRD
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MDPI and ACS Style

Jamet, B.; Zamagni, E.; Nanni, C.; Bailly, C.; Carlier, T.; Touzeau, C.; Michaud, A.-V.; Moreau, P.; Bodet-Milin, C.; Kraeber-Bodere, F. Functional Imaging for Therapeutic Assessment and Minimal Residual Disease Detection in Multiple Myeloma. Int. J. Mol. Sci. 2020, 21, 5406. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21155406

AMA Style

Jamet B, Zamagni E, Nanni C, Bailly C, Carlier T, Touzeau C, Michaud A-V, Moreau P, Bodet-Milin C, Kraeber-Bodere F. Functional Imaging for Therapeutic Assessment and Minimal Residual Disease Detection in Multiple Myeloma. International Journal of Molecular Sciences. 2020; 21(15):5406. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21155406

Chicago/Turabian Style

Jamet, Bastien, Elena Zamagni, Cristina Nanni, Clément Bailly, Thomas Carlier, Cyrille Touzeau, Anne-Victoire Michaud, Philippe Moreau, Caroline Bodet-Milin, and Françoise Kraeber-Bodere. 2020. "Functional Imaging for Therapeutic Assessment and Minimal Residual Disease Detection in Multiple Myeloma" International Journal of Molecular Sciences 21, no. 15: 5406. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms21155406

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