Construction and validation of an ¹⁸F-FDG-PET/CT-based prognostic model to predict progression-free survival in newly diagnosed multiple myeloma patients

ABSTRACT

Objective: To investigate the relationship between ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) related parameters and the prognosis of multiple myeloma and to establish and validate a prediction model regarding the progression-free survival (PFS) of multiple myeloma.

Methods: A retrospective analysis of 126 newly diagnosed multiple myeloma patients who attended Nanjing Drum Tower Hospital from 2014–2021. All patients underwent PET/CT before treatment and were divided into a training cohort (n = 75) and a validation cohort (n = 51). Multivariate Cox proportional hazard regression analysis incorporated PET/CT-related parameters and clinical indicators. A nomogram was established to individually predict PFS in MM patients. The model was evaluated by calculating the C-index and calibration curve.

Results: Here, 4.2 was used as the cut-off value of SUVmax to divide patients into high and low groups. PFS significantly differed between patients in the high-SUVmax group and low-SUVmax group, and SUVmax was an independent predictor of PFS in newly diagnosed multiple myeloma (NDMM) patients. Univariate and multivariate cox regression analysis suggested that lactate dehydrogenase (LDH), bone marrow plasma cell (BMPC), and SUVmax affected PFS. These factors were incorporated to construct a nomogram model for predicting PFS at 1 and 2 years in NDMM patients. The C-index and calibration curves of the nomogram exhibited good accuracy and consistency, and the DCA curves suggested that the model had good clinical utility.

Conclusion: The PET/CT parameter SUVmax is closely related to the prognosis of myeloma patients. The nomogram constructed in this study based on PET/CT-related parameters and clinical indicators individually predicts the PFS rate of NDMM patients and enables further risk stratification of NDMM patients.

KEYWORDS:

• multiple myeloma
• PET/CT
• SUVmax
• nomogram
• PFS

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

This study was approved by the institutional review board of Nanjing Drum Tower Hospital (number: 2023-043-01). The requirement for informed consent was waived owing to the retrospective design of the study.

Availability of data

The data used and analyzed during the current study are available from the corresponding author on reasonable request.

Competing interests

The authors have declared that no competing interest exists.

Author contributions

B. Chen, P. Xu and R. Wang designed the study; X. Dong and R. Wang performed the statistical analysis and drafted the manuscript; J. Xu participated in patient selection and implementation of the study; X. Dong, Y. Peng, X. Ying and J. Yan collected and provided patient data; X. Dong and Y. Peng revised the manuscript. B. Chen and Y. Peng approved the final revision.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [grand number 82273954].