Abstract / Summary
Abstract Purpose To evaluate prognostic value of baseline ¹⁸F-FDG PET/CT Metabolic tumor burden in multiple myeloma. Methods This retrospective, single-center study included 148 patients with newly diagnosed MM who underwent baseline ¹⁸F-FDG PET/CT before systemic therapy. Total metabolic tumor volume (tMTV), total lesion glycolysis (TLG), SUVmax, and morphologic findings were evaluated. Overall survival was analyzed using Kaplan–Meier methods and Cox regression; receiver operating characteristic analyses (ROC) assessed discrimination for mortality. Results Median tMTV, TLG, and SUVmax were 92.55, 272, and 5.2, respectively. Paramedullary and extramedullary disease were present in 37.8% and 11.5% of patients. During a median follow-up of 319 days, 41 patients (27.7%) died. TLG had the highest discrimination for mortality (area under the curve, 0.674), whereas tMTV was the only independent imaging predictor of overall survival among imaging variables (hazard ratio, 1.07 per 100-unit increase; P = .01). The exploratory optimal tMTV threshold was > 288. Conclusion Baseline ¹⁸F-FDG PET/CT-derived volumetric measures provide prognostic information in newly diagnosed MM. tMTV may complement conventional risk assessment, but the proposed threshold requires external validation.