A First Report on [(18)F]FPRGD(2) PET/CT Imaging in Multiple Myeloma

An observational study was set up to assess the feasibility of [(18)F]FPRGD(2) PET/CT for imaging patients with multiple myeloma (MM) and to compare its detection rate with low dose CT alone and combined [(18)F]NaF/[(18)F]FDG PET/CT images. Four patients (2 newly diagnosed patients and 2 with relapsed MM) were included and underwent whole-body PET/CT after injection of [(18)F]FPRGD(2). The obtained images were compared with results of low dose CT and already available results of a combined [(18)F]NaF/[(18)F]FDG PET/CT. In total, 81 focal lesions (FLs) were detected with PET/CT and an underlying bone destruction or fracture was seen in 72 (89%) or 8 (10%) FLs, respectively. Fewer FLs (54%) were detected by [(18)F]FPRGD(2) PET/CT compared to low dose CT (98%) or [(18)F]NaF/[(18)F]FDG PET/CT (70%) and all FLs detected with [(18)F]FPRGD(2) PET were associated with an underlying bone lesion. In one newly diagnosed patient, more [(18)F]FPRGD(2) positive lesions were seen than [(18)F]NaF/[(18)F]FDG positive lesions. This study suggests that [(18)F]FPRGD(2) PET/CT might be less useful for the detection of myeloma lesions in patients with advanced disease as all FLs with [(18)F]FPRGD(2) uptake were already detected with CT alone.