Table 2.
Comparative table of the main characteristics of 18F-Choline or 11C-Choline PET/CT vs. 18FDG PET/CT in multiple myeloma.
| Characteristics | 18F or 11C Choline PET/CT | 18FDG PET/CT |
|---|---|---|
| Cost | >18FDG | <18F or 11C Choline |
| Availability | <18FDG | Widely available |
| Delay between injection and acquisition |
5–20 min (shorter than with 18FDG) | 60 min. |
| Tumor/Background ratio | >18FDG | <18F or 11C Choline |
| Detectability of MM lesions | Up to 70% more lesions than 18FDG | 10% of MM are 18FDG-negative |
| Areas of impaired detection | -FL of right lower ribs: “liver shadowing” -Liver EMD |
Skull FL: “brain shadowing” |
| Effect of Dexamethasone on uptake | Unknown | Impaired uptake |
| Correlation with bone marrow infiltration | Good (R2 = 0.52) | Moderate (R2 = 0.36) |
| False-positive findings | Granulomatosis, neoplasia, inflammatory processes | Neoplasia, inflammatory processes, granulomatosis |
| Prognostic value | Unknown | Proved in multiple studies at baseline and during therapy response assessment |
| Interpretation criteria | Undefined | IMPETUS criteria |
MM: Multiple Myeloma; FL: Focal Lesion; EMD: Extra-Medullary Disease; IMPETUS: Italian Myeloma Criteria for PET Use.