The report came through very quickly. This is a slightly edited version. Basically it's very good and knocks the idea of non-secretory myeloma developing firmly out of the park.
PET whole body fdg vertex to feet.
Direct comparison is made with the previous study of 05/03/20.The metabolic PET fdg data demonstrates a high quality macroscopic metabolic response to therapy, and a maintained high quality response with lenolidamide/Dexamethasone. No clinically significant sites of bony PET activity are defined on the current data.
The dominant plasmacytomas left inferior ilium and acetabulum and the right posterior 4th rib are PET negative, large lytic lesions at these sites being stable compared with the previous CT bone windows. New extraosseous soft tissue components of disease not defined. New sites of active myeloma not defined in terms of the right shoulder territory, the neck or the lower back in particular.
Some small volume lytic sites elsewhere for example base of skull and proximal right femur noted as previous on bone windows.
A small site of persistent PET activity is present deep to the umbilicus, corresponding to 2 cm nodularity affecting the anterior peritoneum at this level, stable since previous, most in keeping with some persistent nonspecific inflammatory type PET activity.
The lungs are well aerated, no pleural or pericardial effusion. Some lung atelectasis noted. No renal or GI obstruction, good volume renal cortices being observed. No splenomegaly.
The previous PET activity tracking along the anterior aspect of the left iliac lesion, which was considered to reflect some bone remodelling on the previous study, is no longer shown. Pathological vertebral collapse is not defined.
The whole-body PET findings are indicative of a high quality macroscopic metabolic response to therapy, with a maintained complete macroscopic remission status being demonstrated on the current PET data. No sites of active macroscopic myeloma are defined on the current PET data. Correlation with the patient's clinical and multiple myeloma markers will also be instructive.
The inflammation under the umbilicus may well be related to the umbilical hernia repair I had done 2002 or thereabouts. The surgeon implanted some strengthening mesh to avoid a recurrence and there may be a slight reaction to that. Nothing to worry about.
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