Cristina Nanni1, Annibale Versari2, Stephane Chauvie3, Elisa Bertone3, Andrea Bianchi4, Marco Rensi5, Marilena Bellò6, Andrea Gallamini7, Francesca Patriarca8, Francesca Gay9, Barbara Gamberi10, Pietro Ghedini11, Michele Cavo12, Stefano Fanti11, Elena Zamagni12. 1. Medicina Nucleare Metropolitana, Bld 30, AOU Policlinico S. Orsola-Malpighi, Via Massarenti, 9, 40138, Bologna, Italy. cristina.nanni@aosp.bo.it. 2. Nuclear Medicine, IRCSS Reggio Emilia, S. Maria Nuova Hospital, Reggio Emilia, Italy. 3. Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy. 4. Nuclear Medicine, Santa Croce e Carle Hospital, Cuneo, Italy. 5. Nuclear Medicine, AOU S. Maria della Misericordia, Udine, Italy. 6. Nuclear Medicine, AO Città della Salute e della Scienza, Torino, Italy. 7. Research, Innovation and Statistics Department. A. Lacassagne Cancer Center, Nice, France. 8. Hematologic Clinic, Udine University, Udine, Italy. 9. Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy. 10. Hematology Unit, IRCCS, Reggio Emilia, S. Maria Nuova Hospital, Reggio Emilia, Italy. 11. Medicina Nucleare Metropolitana, Bld 30, AOU Policlinico S. Orsola-Malpighi, Via Massarenti, 9, 40138, Bologna, Italy. 12. Hematology, AOU Policlinico S. Orsola-Malpighi, Bologna, Italy.
Abstract
ᅟ: FDG PET/CT (18F-fluoro-deoxy-glucose positron emission tomography/computed tomography) is a useful tool to image multiple myeloma (MM). However, simple and reproducible reporting criteria are still lacking and there is the need for harmonization. Recently, a group of Italian nuclear medicine experts defined new visual descriptive criteria (Italian Myeloma criteria for Pet Use: IMPeTUs) to standardize FDG PET/CT evaluation in MM patients. The aim of this study was to assess IMPeTUs reproducibility on a large prospective cohort of MM patients. MATERIALS AND METHODS: Patients affected by symptomatic MM who had performed an FDG PET/CT at baseline (PET0), after induction (PET-AI), and the end of treatment (PET-EoT) were prospectively enrolled in a multicenter trial (EMN02)(NCT01910987; MMY3033). After anonymization, PET images were uploaded in the web platform WIDEN® and hence distributed to five expert nuclear medicine reviewers for a blinded independent central review according to the IMPeTUs criteria. Consensus among reviewers was measured by the percentage of agreement and the Krippendorff's alpha. Furthermore, on a patient-based analysis, the concordance among all the reviewers in terms of positivity or negativity of the FDG PET/CT scan was tested for different thresholds of positivity (Deauville score (DS 2, 3, 4, 5) for the main parameters (bone marrow, focal score, extra-medullary disease). RESULTS: Eighty-six patients (211 FDG PET/CT scans) were included in this analysis. Median patient age was 58 years (range, 35-66 years), 45% were male, 15% of them were in stage ISS (International Staging System) III, and 42% had high-risk cytogenetics. The percentage agreement was superior to 75% for all the time points, reaching 100% of agreement in assessing the presence skull lesions after therapy. Comparable results were obtained when the agreement analysis was performed using the Krippendorff's alpha coefficient, either in every single time point of scanning (PET0, PET-AI or PET-EoT) or overall for all the scans together. DS proved highly reproducible with the highest reproducibility for score 4. CONCLUSIONS: IMPeTUs criteria proved highly reproducible and could therefore be considered as a base for harmonizing PET interpretation in multiple myeloma. A prospective clinical validation of IMPeTUs criteria is underway.
ᅟ: FDG PET/CT (18F-fluoro-deoxy-glucose positron emission tomography/computed tomography) is a useful tool to image multiple myeloma (MM). However, simple and reproducible reporting criteria are still lacking and there is the need for harmonization. Recently, a group of Italian nuclear medicine experts defined new visual descriptive criteria (Italian Myeloma criteria for Pet Use: IMPeTUs) to standardize FDG PET/CT evaluation in MMpatients. The aim of this study was to assess IMPeTUs reproducibility on a large prospective cohort of MMpatients. MATERIALS AND METHODS:Patients affected by symptomatic MM who had performed an FDG PET/CT at baseline (PET0), after induction (PET-AI), and the end of treatment (PET-EoT) were prospectively enrolled in a multicenter trial (EMN02)(NCT01910987; MMY3033). After anonymization, PET images were uploaded in the web platform WIDEN® and hence distributed to five expert nuclear medicine reviewers for a blinded independent central review according to the IMPeTUs criteria. Consensus among reviewers was measured by the percentage of agreement and the Krippendorff's alpha. Furthermore, on a patient-based analysis, the concordance among all the reviewers in terms of positivity or negativity of the FDG PET/CT scan was tested for different thresholds of positivity (Deauville score (DS 2, 3, 4, 5) for the main parameters (bone marrow, focal score, extra-medullary disease). RESULTS: Eighty-six patients (211 FDG PET/CT scans) were included in this analysis. Median patient age was 58 years (range, 35-66 years), 45% were male, 15% of them were in stage ISS (International Staging System) III, and 42% had high-risk cytogenetics. The percentage agreement was superior to 75% for all the time points, reaching 100% of agreement in assessing the presence skull lesions after therapy. Comparable results were obtained when the agreement analysis was performed using the Krippendorff's alpha coefficient, either in every single time point of scanning (PET0, PET-AI or PET-EoT) or overall for all the scans together. DS proved highly reproducible with the highest reproducibility for score 4. CONCLUSIONS: IMPeTUs criteria proved highly reproducible and could therefore be considered as a base for harmonizing PET interpretation in multiple myeloma. A prospective clinical validation of IMPeTUs criteria is underway.
Authors: Andrea Gallamini; Sally F Barrington; Alberto Biggi; Stephane Chauvie; Lale Kostakoglu; Michele Gregianin; Michel Meignan; George N Mikhaeel; Annika Loft; Jan M Zaucha; John F Seymour; Michael S Hofman; Luigi Rigacci; Alessandro Pulsoni; Morton Coleman; Eldad J Dann; Livio Trentin; Olivier Casasnovas; Chiara Rusconi; Pauline Brice; Silvia Bolis; Simonetta Viviani; Flavia Salvi; Stefano Luminari; Martin Hutchings Journal: Haematologica Date: 2014-03-21 Impact factor: 9.941
Authors: Michele Cavo; Evangelos Terpos; Cristina Nanni; Philippe Moreau; Suzanne Lentzsch; Sonja Zweegman; Jens Hillengass; Monika Engelhardt; Saad Z Usmani; David H Vesole; Jesus San-Miguel; Shaji K Kumar; Paul G Richardson; Joseph R Mikhael; Fernando Leal da Costa; Meletios-Athanassios Dimopoulos; Chiara Zingaretti; Niels Abildgaard; Hartmut Goldschmidt; Robert Z Orlowski; Wee Joo Chng; Hermann Einsele; Sagar Lonial; Bart Barlogie; Kenneth C Anderson; S Vincent Rajkumar; Brian G M Durie; Elena Zamagni Journal: Lancet Oncol Date: 2017-04 Impact factor: 41.316
Authors: Twyla B Bartel; Jeff Haessler; Tracy L Y Brown; John D Shaughnessy; Frits van Rhee; Elias Anaissie; Terri Alpe; Edgardo Angtuaco; Ronald Walker; Joshua Epstein; John Crowley; Bart Barlogie Journal: Blood Date: 2009-05-14 Impact factor: 22.113
Authors: Rosa Fonti; Michele Larobina; Silvana Del Vecchio; Serena De Luca; Rossella Fabbricini; Lucio Catalano; Fabrizio Pane; Marco Salvatore; Leonardo Pace Journal: J Nucl Med Date: 2012-10-15 Impact factor: 10.057
Authors: A Paschali; E Panagiotidis; T Triantafyllou; V Palaska; K Tsirou; E Verrou; E Υiannaki; D Markala; A Papanikolaou; A Pouli; P Konstantinidou; V Chatzipavlidou; E Terpos; E Katodritou Journal: Eur J Nucl Med Mol Imaging Date: 2020-10-25 Impact factor: 9.236