Imaging of Multiple Myeloma and Related Plasma Cell Dyscrasias

Walker, Ronald C.; Brown, Tracy L.; Jones-Jackson, Laurie; Blanche, Lorraine De; Bartel, Twyla

doi:10.2967/jnumed.111.098830

Cited by 84 publications

(52 citation statements)

References 73 publications

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“…Our paper supports the idea that CR is not sensitive enough in the assessment of MBD, and that the assessment of the spine and extramedullary lesions using CR is rather poor in comparison with modern imaging methods [1][2][3][4][13][14][15][16] . Still, CR can be used for the detection of osteolytic lesions of the skull, pelvis, ribs and long bones where it has acceptable sensitivity.…”

supporting

confidence: 58%

Prospective comparison of conventional radiography, low-dose computed tomography and magnetic resonance imaging in monoclonal gammopathies

Minařík¹,

Krhovská²,

Pika³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. We carried out a prospective study in order to identify the best imaging approach for patients with newly diagnosed multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS). Methods. We assessed the extent of myeloma bone disease (MBD) in 112 individuals -84 patients with MM and 28 individuals with MGUS. For the detection of osteolytic involvement we used whole-body magnetic resonance imaging (WB-MRI), low-dose computed tomography (LD-CT) and conventional radiography (CR). Each method assessed the presence of osteolytic involvement, compressive fractures and extramedullary involvement in the following regions: skull, spine and chest, pelvis and humerus and femur. We compared the difference in the number and extent of osteolytic involvement, especially the findings in CR negative patients. Results. Conventional radiography showed no superiority in any of the evaluated regions, and failed in the detection of extramedullary massess and spine involvement. WB-MRI was best at imaging the spine including extramedullary involvement, however, detection of osteolytic lesions of the skull was limited in comparison with both CR and LD-CT. Both WB-MRI and LD-CT were comparable in imaging of lesions of pelvis, humerus, femur and the presence of extramedullary masses. LD-CT showed superiority in detection of skull lesions but lower sensitivity in spine compared to WB-MRI. Conclusions. Our results confirm that relying solely on CR in the diagnostics of MM is insufficient. We suggest that the most suitable method for primary assessment of osteolytic involvement in monoclonal gammopathies should include either whole-body MRI together with CR of the skull or, with an equivalent sensitivity, whole body LD-CT.

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supporting

confidence: 58%

Prospective comparison of conventional radiography, low-dose computed tomography and magnetic resonance imaging in monoclonal gammopathies

Minařík¹,

Krhovská²,

Pika³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…1,2 The prognostic implications of PET scanning performed at baseline and after induction and high-dose therapy interventions have recently been reported. 3 Here we investigated the survival implications of the day 7 PET scanning of patients treated with Total Therapy 3A 4 clinical trial and successor protocol Total Therapy 3B 5 protocol.…”

Section: Introductionmentioning

confidence: 99%

Prognostic implications of serial 18-fluoro-deoxyglucose emission tomography in multiple myeloma treated with total therapy 3

Usmani

Mitchell

Waheed

et al. 2013

Blood

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189

126

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“…However, clinical tests revealed liver tumor lesions, which were proven to be an extramedullary manifestation. In this context of possible EMM, MRI and PET-CT are valuable tools to detect lesions with increased FDG avidity [16]. In order to confirm the diagnosis a biopsy should be performed.…”

Section: Discussionmentioning

confidence: 99%

“…The identification of the underlying molecular pathophysiology in EMM might lead us to individualized and targeted therapies in order to overcome the adverse prognosis. Currently, according to the international guidelines, only plain radiography and MRI are recommended for the initial imaging staging [16,17]. However, PET-CT remains a very effective tool to detect extramedullary disease [18].…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with lenalidomide dexamethasone for second relapse of a patient with non-secretory multiple myeloma with extramedullary liver plasmacytomas: A case report

Gavriatopoulou¹,

Terpos²,

Ρούσσου³

et al. 2017

Hematol Med Oncol

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MM is defined as the presence of ≥ 10% of monoclonal plasma cells (PCs) in the bone marrow (or a biopsy-proven extramedullary plasmacytoma) along with endorgan damage due to the underlying disorder. For the majority of myeloma patients, plasma cells are restricted in the bone marrow. However, a small subgroup of patients might develop extramedullary myeloma (EMM), which is defined as the presence of clonal PCs outside the bone marrow. Magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET-CT) are the gold standard imaging techniques for the diagnosis, while biopsy of the lesion is highly recommended. The prognosis is very poor with a median overall survival that does not exceed 6 months. Patients with extramedullary disease are considered as high-risk patients and should be treated accordingly. In this case report we describe the management of a patient with nonsecretory myeloma who relapsed twice with extramedullary disease and we summarize the recommendations for therapeutic approaches of these patients that remain very challenging.

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Imaging of Multiple Myeloma and Related Plasma Cell Dyscrasias

Cited by 84 publications

References 73 publications

Prospective comparison of conventional radiography, low-dose computed tomography and magnetic resonance imaging in monoclonal gammopathies

Prospective comparison of conventional radiography, low-dose computed tomography and magnetic resonance imaging in monoclonal gammopathies

Prognostic implications of serial 18-fluoro-deoxyglucose emission tomography in multiple myeloma treated with total therapy 3

Successful treatment with lenalidomide dexamethasone for second relapse of a patient with non-secretory multiple myeloma with extramedullary liver plasmacytomas: A case report

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