{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:28:48Z","timestamp":1783571328689,"version":"3.55.0"},"reference-count":29,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Economy and Competitiveness","award":["PI 16\/00225"],"award-info":[{"award-number":["PI 16\/00225"]}]},{"name":"Ministry of Economy and Competitiveness","award":["ADE 10\/00028"],"award-info":[{"award-number":["ADE 10\/00028"]}]},{"name":"Ministry of Science and Innovation, Government of Spain","award":["PI 16\/00225"],"award-info":[{"award-number":["PI 16\/00225"]}]},{"name":"Ministry of Science and Innovation, Government of Spain","award":["ADE 10\/00028"],"award-info":[{"award-number":["ADE 10\/00028"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Multiple myeloma (MM) is the second most common haematological malignancy and remains incurable despite therapeutic advances. 18F-FDG (FDG) PET\/CT is a relevant tool MM for staging and it is the reference imaging technique for treatment evaluation. However, it has limitations, and investigation of other PET tracers is required. Preliminary results with L-methyl-[11C]- methionine (MET), suggest higher sensitivity than 18F-FDG. This study aimed to compare the diagnostic accuracy and prognostic value of 1FDG and MET in MM patients. We prospectively compared FDG and MET PET\/CT for assessment of bone disease and extramedullary disease (EMD) in a series of 52 consecutive patients (8 smoldering MM, 18 newly diagnosed MM and 26 relapsed MM patients). Bone marrow (BM) uptake patterns and the detection of focal lesions (FLs) and EMD were compared. Furthermore, FDG PET parameters with known MM prognostic value were explored for both tracers, as well as total lesion MET uptake (TLMU). Median patient age was 61 years (range, 37\u201383 years), 54% were male, 13% of them were in stage ISS (International Staging System) III, and 31% had high-risk cytogenetics. FDG PET\/CT did not detect active disease in 6 patients, while they were shown to be positive by MET PET\/CT. Additionally, MET PET\/CT identified a higher number of FLs than FDG in more than half of the patients (63%). For prognostication we focussed on the relapsed cohort, due to the low number of progressions in the two other cohorts. Upon using FDG PET\/CT in relapsed patients, the presence of more than 3 FLs (HR 4.61, p = 0.056), more than 10 FLs (HR 5.65, p = 0.013), total metabolic tumor volume (TMTV) p50 (HR 4.91, p = 0.049) or TMTV p75 (HR 5.32, p = 0.016) were associated with adverse prognosis. In MET PET\/CT analysis, TMTV p50 (HR 4.71, p = 0.056), TMTV p75 (HR 6.27, p = 0.007), TLMU p50 (HR 8.8, p = 0.04) and TLMU p75 (HR 6.3, p = 0.007) adversely affected PFS. This study confirmed the diagnostic and prognostic value of FDG in MM. In addition, it highlights that MET has higher sensitivity than FDG PET\/CT for detection of myeloma lesions, including FLs. Moreover, we show, for the first time, the prognostic value of TMTV and TLMU MET PET\/CT in the imaging evaluation of MM patients.<\/jats:p>","DOI":"10.3390\/ijms23179895","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T01:50:51Z","timestamp":1661997051000},"page":"9895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["11C-Methionine PET\/CT in Assessment of Multiple Myeloma Patients: Comparison to 18F-FDG PET\/CT and Prognostic Value"],"prefix":"10.3390","volume":"23","author":[{"given":"Maria I.","family":"Morales-Lozano","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Clinica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Rodriguez-Otero","sequence":"additional","affiliation":[{"name":"Department of Haematology, Cl\u00ednica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1666-072X","authenticated-orcid":false,"given":"Lidia","family":"Sancho","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Clinica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge M.","family":"Nu\u00f1ez-Cordoba","sequence":"additional","affiliation":[{"name":"Research Support Service, Central Clinical Trials Unit, Clinica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3609-1210","authenticated-orcid":false,"given":"Elena","family":"Prieto","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Clinica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8038-972X","authenticated-orcid":false,"given":"Maria","family":"Marcos-Jubilar","sequence":"additional","affiliation":[{"name":"Department of Haematology, Cl\u00ednica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9791-6186","authenticated-orcid":false,"given":"Juan J.","family":"Rosales","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Clinica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Department of Haematology, Cl\u00ednica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5693-9311","authenticated-orcid":false,"given":"Edgar F.","family":"Guillen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Clinica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"San-Miguel","sequence":"additional","affiliation":[{"name":"Department of Haematology, Cl\u00ednica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0829-2808","authenticated-orcid":false,"given":"Maria J.","family":"Garcia-Velloso","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Clinica Universidad de Navarra, CCUN Applied Medical Research, Instituto de Investigaci\u00f3n Sanitaria de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1365-2141.2004.05207.x","article-title":"A population study to define the incidence and survival of multiple myeloma in a National Health Service Region in UK","volume":"127","author":"Phekoo","year":"2004","journal-title":"Br. 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Imaging"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/17\/9895\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:20:49Z","timestamp":1760142049000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/17\/9895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,31]]},"references-count":29,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["ijms23179895"],"URL":"https:\/\/doi.org\/10.3390\/ijms23179895","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,31]]}}}