Current and Future PET Imaging for Multiple Myeloma

Positron emission tomography (PET) is an imaging modality used for the noninvasive assessment of tumor staging and response to therapy. PET with F-18 labeled fluorodeoxyglucose (F-18-FDG PET) is widely used to assess the active and inactive lesions in patients with multiple myeloma (MM). Despite the availability of F-18-FDG PET for the management of MM, PET imaging is less sensitive than next-generation flow cytometry and sequencing. Therefore, the novel PET radiotracers Cu-64-LLP2A, Ga-68-pentixafor, and Zr-89-daratumumab have been developed to target the cell surface antigens of MM cells. Furthermore, recent studies attempted to visualize the tumor-infiltrating lymphocytes using PET imaging in patients with cancer to investigate their prognostic effect; however, these studies have not yet been performed in MM patients. This review summarizes the recent studies on PET with F-18-FDG and novel radiotracers for the detection of MM and the resulting preclinical research using MM mouse models and clinical studies. Novel PET technologies may be useful for developing therapeutic strategies for MM in the future.

Automated summary

Positron emission tomography (PET) is a method used for the evaluation of tumor staging and response to therapy in a noninvasive manner. While PET with F-18 labeled fluorodeoxyglucose (F-18-FDG PET) is commonly used for assessing lesions in multiple myeloma patients, it is less sensitive compared to next-generation flow cytometry and sequencing. Novel PET radiotracers, such as Cu-64-LLP2A, Ga-68-pentixafor, and Zr-89-daratumumab, have been developed to target cell surface antigens of MM cells. Recent studies have focused on visualizing tumor-infiltrating lymphocytes using PET imaging in cancer patients, but these studies have not been performed in MM patients. This review highlights the recent research on PET with F-18-FDG and novel radiotracers for MM detection, including preclinical studies using MM mouse models and clinical investigations. Novel PET technologies may have potential for developing therapeutic strategies for MM in the future.