Whole-body low-dose multidetector row-CT in the diagnosis of multiple myeloma: an alternative to conventional radiography

2005 ◽  
Vol 54 (2) ◽  
pp. 289-297 ◽  
Author(s):  
Marius Horger ◽  
Claus D. Claussen ◽  
Ulrike Bross-Bach ◽  
Reinhard Vonthein ◽  
Tobias Trabold ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Low Dose ◽  
Conventional Radiography ◽  
Whole Body ◽  
Multidetector Row Ct ◽  
Multidetector Row

Skeletal Survey in Multiple Myeloma: Role of Imaging

2021 ◽  
Vol 17 ◽  
Author(s):  
Paolo Spinnato ◽  
Giacomo Filonzi ◽  
Alberto Conficoni ◽  
Giancarlo Facchini ◽  
Federico Ponti ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Low Dose ◽  
Imaging Modality ◽  
Bone Marrow Involvement ◽  
Conventional Radiography ◽  
Response To Therapy ◽  
Whole Body ◽  
Initial Assessment ◽  
Bone Lesions ◽  
Pet Ct

: Bone disease is the hallmark of multiple myeloma. Skeletal lesions are evaluated to establish the diagnosis, to choose the therapies and also to assess the response to treatments. Due to this, imaging procedures play a key-role in the management of multiple myeloma. For decades, conventional radiography has been the standard imaging modality. Subsequently, advances in the treatment of multiple myeloma have increased the need for accurate evaluation of skeletal disease. The introduction of new high performant imaging tools, such as whole-body low dose computed tomography, different types of magnetic resonance imaging studies, and 18F-fluorodeoxyglucose positron emission tomography, replaced conventional radiography. In this review we analyze the diagnostic potentials, indications of use, and applications of the imaging tools nowadays available. Whole body low-dose CT should be considered as the imaging modality of choice for the initial assessment of multiple myeloma lytic bone lesions. MRI is the gold-standard for detection of bone marrow involvement, while PET/CT is the preferred technique in assessment of response to therapy. Both MRI and PET/CT are able to provide prognostic information.

scholarly journals Whole-Body Low-Dose Multidetector-Row CT in Multiple Myeloma: Guidance in Performing, Observing, and Interpreting the Imaging Findings

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1320
Author(s):  
Antonio Pierro ◽  
Alessandro Posa ◽  
Costanzo Astore ◽  
Mariacarmela Sciandra ◽  
Alessandro Tanzilli ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Low Dose ◽  
Plasma Cells ◽  
Traditional Approach ◽  
Response To Treatment ◽  
Whole Body ◽  
Newly Diagnosed ◽  
Low Dose Ct ◽  
Lytic Lesions ◽  
Total Body

Multiple myeloma is a hematological malignancy of plasma cells usually detected due to various bone abnormalities on imaging and rare extraosseous abnormalities. The traditional approach for disease detection was based on plain radiographs, showing typical lytic lesions. Still, this technique has many limitations in terms of diagnosis and assessment of response to treatment. The new approach to assess osteolytic lesions in patients newly diagnosed with multiple myeloma is based on total-body low-dose CT. The purpose of this paper is to suggest a guide for radiologists in performing and evaluating a total-body low-dose CT in patients with multiple myeloma, both newly-diagnosed and in follow-up (pre and post treatment).

Whole-Body Low-Dose CT in Multiple Myeloma: Diagnostic Value of Appendicular Medullary Patterns of Attenuation

2021 ◽  
Vol 216 (3) ◽  
pp. 742-751
Author(s):  
Vassilis Koutoulidis ◽  
Evangelos Terpos ◽  
Ioanna Klapa ◽  
George Cheliotis ◽  
Ioannis Ntanasis-Stathopoulos ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Low Dose ◽  
Diagnostic Value ◽  
Whole Body ◽  
Low Dose Ct

Impact of Whole-Body Magnetic Resonance Imaging on Staging in Patients with Newly Diagnosed Plasma Cell Disease.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5061-5061
Author(s):  
Martin Zoz ◽  
Andreas Baldauf ◽  
Anne Schipp ◽  
Jens Hillengass ◽  
Anthony D. Ho ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Conventional Radiography ◽  
Whole Body ◽  
Newly Diagnosed ◽  
Resonance Imaging ◽  
Cell Disease ◽  
Body Magnetic Resonance Imaging

Abstract INTRODUCTION: MRI has a high sensitivity in determining changes in bone marrow induced by metastatic disease or primary neoplasms of the bone marrow. Whole-Body Magnetic Resonance Imaging (WB-MRI) is a novel imaging technique that displays nearly the complete skeletal system in one exam. We investigated the differences between conventional skeletal survey and WB-MRI and their impact on staging of patients with newly diagnosed plasma cell disease. METHOD AND MATERIALS: In 41 consecutive patients with newly diagnosed MGUS (n=5), Multiple Myeloma (n=34) or AL-Amyloidosis (n=2) conventional radiographs and WB-MRI (coronar T1 tse and T2 tirm sequences and sagittal T2 star sequences, 1,5 T MRI with parallel imaging, Siemens Avanto®) were performed. Radiographs and scans were evaluated for diffuse and focal bone marrow involvement in consent by two experienced radiologists blinded for patient name and study time. Staging was performed including clinical data according to the Salmon/Durie classification system and the Durie/Salmon PLUS classification system with inclusion of WB-MRI. RESULTS: In 24 (59%) patients there were no lesions in conventional radiography or MRI. In 17 (41 %) patients results of MRI and conventional radiography were discrepant. 4 (10%) patients had lesions only in MRI, 3 (7%) only in conventional radiography and 10 (24%) in both techniques but in different localization. In 16 (38%) patients with radiological signs of osteopenia there was no diffuse infiltration in MRI or vice versa. We systematically analysed the consequences of WB-MRI on staging of patients based on the newly proposed staging system Durie/Salmon PLUS. Replacing conventional radiographs by WB-MRI resulted in reclassification of 12 patients. 3 patients were reclassified from MGUS or stage I into stage II or III. 9 patients were downstaged from stage III or II into stage I or MGUS. CONCLUSION: WB-MRI is a valuable technique for the initial work-up of patients with Multiple Myeloma. In comparison with conventional skeletal survey there are often differing results with impact on clinical staging and influence on therapy decision. WB-MRI can give additional information in patients with unclear staging situation before onset of therapy. Further evaluation of WB-MRI within prospective studies is warranted in particular with respect to prognostic impact regarding overall prognosis as well as regarding local complications. Until then WB-MRI should be used complementary to conventional radiography or CT-techniques that provide accurate imaging of the bone.

The benefit of whole-body low-dose unenhanced multidetector computer tomography (WBLD-MDCT) for follow up and therapy response monitoring in patients with multiple myeloma: Correlation with hematologic parameters

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7607-7607
Author(s):  
M. S. Horger ◽  
C. Driessen ◽  
C. Brodoefel ◽  
C. Faul ◽  
P. Pereira ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Computer Tomography ◽  
Low Dose ◽  
Laboratory Data ◽  
Whole Body ◽  
Acquisition Time ◽  
Bone Lesions ◽  
Appendicular Skeleton ◽  
Multidetector Computer Tomography

7607 Background: To assessthe value of whole-body low-dose multidetector computer tomography (WBLD-MDCT) as diagnostic and survey modality in multiple myeloma (MM), and as a one-stop alternative (Horger et al. EJR 2005;54:289–297) to established imaging techniques (e.g. x-ray and MRI). Methods: Between 7/2001 and 2/2005, WBLD-MDCT scans were obtained in 90 consecutive patients with histologically proven stage II-III MM, all patients having 2 or more scans (mean = 3,8; range = 2–6). CT-scans were performed using a standardized low-dose protocol and the number, size and density of focal or diffuse medullary (in the appendicular skeleton and pelvis) and extra-medullary lesions as well as osteolysis were analysed for each examination and at follow up. Results were correlated with current standard MM laboratory data and at follow up in order to assess correct temporal recognition of significant myeloma changes by both methods. Results: Detection and follow up of medullary and extra-medullary MM lesions and osteolysis by WBLD-MDCT resulted in a sensitivity of 92%, a specificity of 93%, a NPV of 95%, a PPV of 85% and a likelihood ratio for patients with CT-abnormalities to present changes in the course of their disease of 12. Results of radiologic and hematologic analysis showed high agreement at follow up (median, 3 mo). However, agreement of both techniques at the time of investigation was only moderate (κ = 0.629), with CT being correct in 60% of mismatching cases. Thus, CT enabled earlier detection of MM changes. WBLD-MDCT assessed correctly the course of disease in all 4 patients with nonsecretory MM. Evaluation of stability was optimal in all patients. Conclusions: WBLD-MD represents a reliable, widespread, quick (75s acquisition time), and cost-effective imaging technique in MM, allowing detection of bone marrow involvement, extra-medullary tumors and lytic bone lesions in different clinical settings (staging, follow up, therapy monitoring, evaluation of stability). WBLD-MDCT repeatedly allowed detection of changes in the course of the disease prior to laboratory data, especially in extramedullary MM relapse and nonsecretory MM. No significant financial relationships to disclose.

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

2014 ◽  
Vol 20 (23) ◽  
pp. 5888-5897 ◽  
Author(s):  
Matthew J. Pianko ◽  
Evangelos Terpos ◽  
G. David Roodman ◽  
Chaitanya R. Divgi ◽  
Sonja Zweegman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multiple Myeloma ◽  
Bone Disease ◽  
Low Dose ◽  
Imaging Techniques ◽  
Whole Body ◽  
Advanced Imaging ◽  
Myeloma Bone Disease ◽  
Low Dose Computed Tomography

Bones in Multiple Myeloma: Imaging and Therapy

2018 ◽  
pp. 638-646 ◽  
Author(s):  
Elena Zamagni ◽  
Michele Cavo ◽  
Bita Fakhri ◽  
Ravi Vij ◽  
David Roodman
Keyword(s):  
Multiple Myeloma ◽  
Bone Disease ◽  
Standard Of Care ◽  
Conventional Radiography ◽  
Imaging Modalities ◽  
Whole Body ◽  
Clinical Feature ◽  
Bone Lesions ◽  
Low Sensitivity ◽  
Fdg Pet Ct

Bone disease is the most frequent disease-defining clinical feature of multiple myeloma (MM), with 90% of patients developing bone lesions over the course of their disease. For this reason, imaging plays a major role in the management of disease in patients with MM. Although conventional radiography has traditionally been the standard of care, its low sensitivity in detecting osteolytic lesions has called for more advanced imaging modalities. In this review, we discuss the advantages, indications, and applications of whole-body low-dose CT (WBLDCT), 18F-fluorodeoxyglucose (FDG)-PET/CT, MRI, and other novel imaging modalities in the management of disease in patients with plasma cell dyscrasias. We also review the state of the art in treatment of MM bone disease (MMBD) and the role of bisphosphonates and denosumab, a monoclonal antibody that binds and blocks the activity of receptor activator of nuclear factor-kappa B ligand (RANKL), which was recently approved by the U.S. Food and Drug Administration for MMBD.

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