Detecting the Onset of Multiple Myeloma Using 18F-NaF and 18F-FDG PET/CT Imaging
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Multiple myeloma (MM), a cancer of blood plasma cells, is preceded by a nonmalignant state, Monoclonal Gammopathy of Undetermined Significance (MGUS). The reason for the transition from MGUS to MM is unknown, but many factors seem to influence the transition, including osteoblast activity and increased glycolysis. It is important to develop a method to detect the transition from MGUS to MM because it is difficult to predict which patients will progress to MM, preventing diagnosis of the disease until its advanced stages. Molecular imaging techniques are useful for diagnosis of MM. However, current methods only diagnose the disease's advanced stages. This study used PET/CT imaging inNOD.CB17-Prkdcsc"Vj mice; imaged with ,8F-NaF, a tracer approved for bone scans, and 18F-FDG, the most widely used PET imaging tracer; to detect the onset of MM. Osteoblasts preferentially take up 18F-NaF, and are an important pathological 1 8 characteristic of early stage MM, while F-FDG is taken up in areas of increased metabolism, a characteristic observed in MM and many other types of cancer. Overall, we did not observe a significant difference in the amount of 18F-NaF or I8F-FDG uptake between the control and experimental mice. Our results suggest that characteristics of the mouse model, such as sensitivity to radiation and age, may cause the results to be different than we would expect. This study highlighted the importance of early diagnosis and the need and complexity of developing a highly specific diagnostic imaging technique for MM.