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Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography at diagnosis in untreated multiple myeloma patients: a systematic review and meta-analysis

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Abstract

Multiple myeloma is a clonal B-lymphocyte tumor of terminally differentiated plasma cells. 18F-FDG PET/CT can provide valuable data for the diagnosis, restaging, and evaluate prognosis of multiple myeloma (MM). This meta-analysis aimed to evaluate the prognostic value of pre-treatment 18F-FDG PET/CT at diagnosis in MM patients. Related researches came from Embase, PubMed, and Cochrane Library databases through a systematic search, and the last one was updated on April 26, 2021. Cochran Q test and I-squared statistics were used to test for heterogeneity among the studies analyzed. The fixed model and random model were used to combine results when appropriate. Stata 12.0 was used to perform statistical analysis, and p < 0.05 was considered statistically significant. A total of 16 articles with 2589 patients were included in this study. Our results indicated PET/CT has an excellent prognostic role in MM, that higher SUVmax, more FL and EMD were associated with poor OS and PFS. SUVmax: OS (HR 1.89, 95% CI 1.47–2.44), PFS (HR 1.34, 95% CI 1.18–1.51); Fl: OS (HR 2.65, 95% CI 1.83–3.79), PFS (HR 1.61, 95% CI 1.40–1.86); EMD: OS (HR 2.11, 95% CI 1.41–3.16), PFS (HR 2.18, 95% CI 1.69–2.81). Furthermore, similar results were observed in most subgroup analyzes. Conclusion Pre-treatment 18F-FDG PET/CT examination has prognostic value for myeloma patients and has guiding significance for clinical treatment.

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Abbreviations

18F-FDG PET/CT:

18F-fluorodeoxyglucose positron emission tomography/computed tomography

CI:

Confidence Intervals

EMD:

Extramedullary disease

FL:

Focal lesions

HR:

Hazard Ratio

ISS:

International Staging System

MM:

Multiple myeloma

MRI:

Magnetic resonance imaging

NA:

Not available

NOS:

Newcastle–Ottawa Quality Assessment Scale

OS:

Over survival

PFS:

Progress-free survival

Pro:

Prospective study

Retro:

Retrospective study

SUVmax :

Standardized uptake value maximum

WBLDCT:

Whole-body low-dose CT

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Funding

This work was supported by the National Natural Science Foundation of China: [Grant Number 81670179]; Major Subject of Science and Technology of Anhui Province: [Grant Number 201903a07020030].

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Author notes

  1. Qian Li and Linhui Hu have contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology/Hematological Lab, The Second Hospital of Anhui Medical University, Hefei, 230601, Anhui Province, People’s Republic of China

    Qian Li, Linhui Hu, Alice Charwudzi, Weiwei Zhu, Ye Meng & Zhimin Zhai

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  1. Qian Li
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  2. Linhui Hu
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  3. Alice Charwudzi
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  4. Weiwei Zhu
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Contributions

QL and LHH performed data collection and analyzed the data. ZMZ approved the final manuscript as submitted. QL, LHH, MLX, AC, WWZ, YM and ZMZ wrote the manuscript.

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Correspondence to Zhimin Zhai.

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Li, Q., Hu, L., Charwudzi, A. et al. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography at diagnosis in untreated multiple myeloma patients: a systematic review and meta-analysis. Clin Exp Med 23, 31–43 (2023). https://doi.org/10.1007/s10238-021-00775-z

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