Multidetector CT of the Spine in Multiple Myeloma: Comparison with MR  Imaging and Radiography

Mahnken, Andreas H.; Wildberger, Joachim E.; Gehbauer, Gerald; Schmitz‐Rode, Thomas; Blaum, Marcus; Fabry, U.; Günther, Rolf W.

doi:10.2214/ajr.178.6.1781429

Cited by 183 publications

(109 citation statements)

References 15 publications

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“…Heterogeneous osteoporosis in a population at risk may be misinterpreted as osteolytic lesions representative of multiple myeloma (15). Conversely, WBLDCT may not detect diffuse marrow involvement with homogenous-appearing cortical bone destruction that could be mistaken for osteoporosis or osteopenia (31,32).…”

Section: Imaging For Surveillance and Prognosticationmentioning

confidence: 99%

Whole-Body Low-Dose Computed Tomography and Advanced Imaging Techniques for Multiple Myeloma Bone Disease

Pianko

Terpos

Roodman

et al. 2014

Clinical Cancer Research

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Detection of lytic bone lesions is crucial in the workup for multiple myeloma and very often dictates the decision to start treatment. Conventional radiography, despite decades of use, is often insufficient for detection of bone disease in multiple myeloma. Modern imaging techniques such as MRI, PET, and CT offer superior detection of myeloma bone disease and extramedullary manifestations of plasma cell dyscrasias. Novel whole-body low-dose computed tomography (WBLDCT) protocols allow for collection of superior image detail of the skeleton at doses of radiation similar to those used for conventional planar radiography. Several studies have shown that WBLDCT has a superior detection rate for lytic bone lesions compared with whole-body X-ray (WBXR), potentially leading to restaging and changes in therapy. MRI and PET provide imaging data important for assessing disease activity and prognostication. Because of several advantages over WBXR, WBLDCT is already the standard imaging technique for use in patients with multiple myeloma in many European institutions. However, the radiographic skeletal survey or WBXR is still the initial study of choice used to screen for myeloma bone disease in many institutions. In this review, we aim to explore the changing landscape of imaging for myeloma bone disease through use of modern imaging techniques. Clin Cancer Res; 20(23); 5888-97. Ó2014 AACR.

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Section: Imaging For Surveillance and Prognosticationmentioning

confidence: 99%

Whole-Body Low-Dose Computed Tomography and Advanced Imaging Techniques for Multiple Myeloma Bone Disease

Pianko

Terpos

Roodman

et al. 2014

Clinical Cancer Research

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show abstract

“…Like MRI, it is able to detect extramedullary processes, and when combined with positron emission tomography (as PET/CT) it can assess the activity of the process [2][3][4]20 . Due to high radiation exposure associated with CT scans, effort has focused at reducing it using "lowdose" schedules [7][8][9]22 . The final image of "low-dose" CT is not as sensitive for soft tissue visualisation but it retains sensitivity for detection of bone involvement.…”

Section: 2413-16mentioning

confidence: 99%

“…Aiming for the most suitable, economical and easily available technique for routine practice, we chose low-dose computed tomography out of the CT-based imaging techniques for our study. LD-CT is an easily accessible method (using an ordinary CT machine) with similar costs and just slightly elevated radiation exposure in comparison with conventional radiography 6,7,22 . As shown by the present paper, LD-CT is more sensitive than WB-MRI on the skull, and it has similar sensitivity on pelvis and "long bones" including extramedullary involvement.…”

Section: 2413-16mentioning

confidence: 99%

“…Although there are many new imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) or positron emission tomography (PET), conventional radiography (CR) has been for long considered to be the "gold standard" in majority of individuals with newly diagnosed monoclonal gammopathies. Several papers reported on its limited sensitivity and the need for more sophisticated imaging [6][7][8][9][10] . Until 2014, the guidelines of the International Myeloma Working Group (IMWG) acknowledged the benefit of modern imaging, especially of MRI but recommended it only in specific situations such as in "MM patients with normal conventional radiography and in all patients with apparently solitary plasmocytoma of bone", and as an urgent procedure in the suspicion of cord compression 1 .…”

Section: Introductionmentioning

confidence: 99%

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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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“…Multidetector CT is more sensitive than plain radiography in assessment of anatomically complex regions such as the thoracic spine (57). Multidetector CT and MR imaging are complementary in initial evaluation of multiple myeloma, as MR imaging may result in understaging in 10%-20% of patients with stage III multiple myeloma and proved bone marrow infiltration (58).…”

Section: Multiple Myelomamentioning

confidence: 99%

Put Your Back into It: Pathologic Conditions of the Spine at Chest CT

Meyer

Vagal²,

Seaman³

2011

RadioGraphics

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Multidetector CT of the Spine in Multiple Myeloma: Comparison with MR Imaging and Radiography

Cited by 183 publications

References 15 publications

Whole-Body Low-Dose Computed Tomography and Advanced Imaging Techniques for Multiple Myeloma Bone Disease

Whole-Body Low-Dose Computed Tomography and Advanced Imaging Techniques for Multiple Myeloma Bone Disease

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

Put Your Back into It: Pathologic Conditions of the Spine at Chest CT

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