18F-FDG PET/CT focal, but not osteolytic, lesions predict the progression of smoldering myeloma to active disease

E. Zamagni, Cristina Nanni, Francesca Gay, Annalisa Pezzi, F. Patriarca, M. Bellò, Ilaria Rambaldi, Paola Tacchetti, Jens Hillengass, Barbara Gamberi, Lucia Pantani, Valeria Magarotto, Annibale Versari, Massimo Offidani, Beatrice Anna Zannetti, Francesca Carobolante, M. Balma, Pellegrino Musto, Marco Rensi, Katia MancusoA. Dimitrakopoulou-Strauss, Stéphane Chauvie, Serena Rocchi, N. Fard, Giulia Marzocchi, Giovanni Storto, P. Ghedini, A. Palumbo, S. Fanti, Michele Cavo

Research output: Contribution to journalArticlepeer-review


Identification of patient sub-groups with smoldering multiple myeloma (SMM) at high risk of progression to active disease (MM) is an important goal. 18F-FDG PET/CT (positron emission tomography (PET) integrated with computed tomography (PET/CT) using glucose labelled with the positron-emitting radionuclide 18 F) allows for assessing early skeletal involvement. Identification of osteolytic lesions by this technique has recently been incorporated into the updated International Myeloma Working Group criteria for MM diagnosis. However, no data are available regarding the impact of focal lesions (FLs) without underlying osteolysis on time to progression (TTP) to MM. We hence prospectively studied a cohort of 120 SMM patients with PET/CT. PET/CT was positive in 16% of patients (1 FL: 8, 2 FLs: 3, >3 FLs: 6, diffuse bone marrow involvement: 2). With a median follow-up of 2.2 years, 38% of patients progressed to MM, in a median time of 4 years, including 21% with skeletal involvement. The risk of progression of those with positive PET/CT was 3.00 (95% confidence interval 1.58-5.69, P=0.001), with a median TTP of 1.1 versus 4.5 years for PET/CT-negative patients. The probability of progression within 2 years was 58% for positive versus 33% for negative patients. In conclusion, PET/CT positivity significantly increased the risk of progression of SMM to MM. PET/CT could become a new tool to define high-risk SMM.

Original languageEnglish
Pages (from-to)417-422
Number of pages6
Issue number2
Publication statusPublished - Feb 1 2016

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine


Dive into the research topics of '18F-FDG PET/CT focal, but not osteolytic, lesions predict the progression of smoldering myeloma to active disease'. Together they form a unique fingerprint.

Cite this