Novel Interpretation Criteria (Italian Myeloma Criteria for Positron Emission Tomography Use) Its Prognostic Significance for Fluorodeoxyglucose Labeled with Fluorine-18 Positron Emission Tomography / Computed Tomography in Multiple Myeloma

Background: Multiple Myeloma (MM) is a hematologic malignancy characterized by the proliferation of abnormal plasma cells. Despite advancements in treatment, the management of MM remains challenging due to varying bone marrow involvement, Extramedullary disease (EMD), and the need for standardized imaging evaluation. Objectives:This study aimed to evaluate the prognostic significance of the Italian Myeloma Criteria forpositron emission tomography (PET) Use (IMPeTUs) in MM patients receiving High-Dose Chemotherapy (HDT). Patients and methods: This prospective study was performed on 42 recently diagnosed symptomatic MM patients at Benha University Hospitals between October 2023 and October 2024. All patients underwent whole-bodyFluorodeoxyglucose labeled with Fluorine-18 Positron Emission Tomography/ Computed Tomography [18F] FDG PET/CT imaging before and after treatment, with assessments based on the IMPeTUs criteria. Results: Significant improvements were observed at follow-up, including a decrease in Deauville score (DS) and hypermetabolic lesions. The occurrence of spine lesions and the uptake of the most intense focal lesion significantly decreased. The number of lytic lesions decreased, and there was a notable reduction in the number of lesions in patients treated with chemotherapy compared to baseline. However, there were no significant changes in EMD,Para Medullary Disease (PMD), or fractures. Conclusion: Follow-up PET/CT imaging using IMPeTUs criteria offered valuable prognostic information and provided insight into treatment response in MM patients undergoing HDT, supporting its potential for clinical application in improving patient management.