The Role of Whole-Body Imaging in the Diagnosis, Staging, and Follow-Up of Multiple Myeloma

Abstract Introduction: Conventional radiography remains the “gold standard” technique for bone involvement assessment in patients with multiple myeloma (MM). Newer imaging modalities such as whole-body Magnetic Resonance (MR) and 18FDG-PET/CT have emerged as more sensitive techniques than routine skeletal survey in the detection of bone involvement in the diagnostic and follow up of patients with MM. The advantages and disadvantages of MR and 18FDG-PET/CT are discussed. Patients and methods: We have retrospectively analyzed 12 patients since 2012 to 2014 with multiple myeloma in our institution whose bone involvement was evaluated with MR and 18FDG-PET/CT. Age range: 36-70. Seven patients were female and five were male. Eight cases were treated with an induction regimen containing bortezomib, three cases with chemotherapy with alternating VBCMP/VBAD and one of them with VAD. After induction, ten of them received autologous stem cell transplantation (ASCT), one patient allogeneic stem cell transplantation and one patient no transplantation. Results: All patients presented bone lesions on MR and all of them were also positive at PET/CT. One showed leptomeningeal involvement on RM and PET. Regarding extramedullar disease two patients presented soft tissue masses and in other two cases there was ganglionar involvement, all of them positives by both techniques. Of nine evaluable patients after complete treatment, six of them have a negative PET and three have a low positive SUV value, however eight of them still had persistent residual lesions on MR, what could indicate not stringent complete response. The patient with leptomeningeal involvement had both MR and PET negative result after treatment. Comments and conclusions: Our data suggest that whole-body MR and 18FDG-PET/CT provide valuable complementary information, MR could be superior to assess extent of lesions and PET to monitor disease activity and to detect asymptomatic relapse. The optimal imaging technique for the management of patients with MM is not well defined and our proposal is a multimodality imaging approach according to individualized criteria. References: Caers J et al. The role of positron emission tomography-computed and magnetic resonance imaging in diagnosis and follow-up of multiple myeloma. Haematologica 2014;99(4):629-637. doi:10.3324/haematol.2013.091918. Agarwal A et al. Evolving Role of FDG PET/CT in Multiple Myeloma Imaging and Management. AJR 2013;200:884-890. Dimopoulos D et al. International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia 2009, 1–12. doi:10.1038/leu.2009.89 Disclosures Alegre: Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Jansen: Membership on an entity's Board of Directors or advisory committees, Research Funding.

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Whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in prostate cancer: Prevalence and clinical significance of incidental findings

British Journal of Radiology ◽

10.1259/bjr.20210459 ◽

2021 ◽

pp. 20210459

Author(s):

Soma Kumasaka ◽

Shunichi Motegi ◽

Yuka Kumasaka ◽

Tatsuya Nishikata ◽

Masami Otomo ◽

...

Keyword(s):

Prostate Cancer ◽

Incidental Findings ◽

Whole Body ◽

Whole Body Imaging ◽

Resonance Imaging ◽

Body Imaging ◽

Signal Suppression ◽

Body Magnetic Resonance Imaging ◽

Clinically Significant

Objective: Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) is now recommended as a first-line staging modality in prostate cancer patients, and the widespread use of DWIBS may lead to an increased frequency of incidental findings. The aim of this study was to evaluate the prevalence and clinical significance of incidental findings on whole-body magnetic resonance imaging (WB-MRI) with DWIBS. Methods: Data from 124 patients with prostate cancer (age, 76.5 ± 5.6 years), who underwent 1.5 T WB-MRI with STIR, TSE-T2, TSE-T1, In/Out GRE, and DWIBS sequences, were retrospectively analyzed. Findings unrelated to prostate cancer were considered as incidental findings and categorized into two groups based on their clinical implications, as follow: imaging follow-up or additional examinations was required (significant incidental findings) and no need to additional work-up (non-significant incidental findings). A Chi-square test was performed to compare the differences in the prevalence of significant incidental findings based on age (≤75 and>75 years old). Results: A total of 334 incidental findings were found, with 8.1% (n = 27) as significant incidental findings. Significant incidental findings were more frequent in patients over 75 years old than those of 75 years old or younger (28.6% vs 11.1%, p = 0.018). Conclusion: Clinically significant incidental findings, which required imaging follow-up or additional examinations, were commonly observed in prostate cancer patients on WB-MRI/DWIBS. Advances in knowledge: Some incidental findings were clinically significant which may lead to changes in treatment strategy. Checking the entire organ carefully for abnormalities, and reporting any incidental findings detected are important.

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Whole-Body Imaging of Multiple Myeloma: Diagnostic Criteria

RadioGraphics ◽

10.1148/rg.2019180096.pres ◽

2019 ◽

Author(s):

Alípio G. Ormond Filho ◽

Bruno C. Carneiro ◽

Daniel Pastore ◽

Igor P. Silva ◽

Sâmia R. Yamashita ◽

...

Keyword(s):

Multiple Myeloma ◽

Diagnostic Criteria ◽

Whole Body ◽

Whole Body Imaging ◽

Body Imaging

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2SC-02 Coordination of mitosis and morphogenesis : Role of a prolonged G2 phase during chordate neural tube closure(2SC Whole body imaging,The 49th Annual Meeting of the Biophysical Society of Japan)

Seibutsu Butsuri ◽

10.2142/biophys.51.s15_6 ◽

2011 ◽

Vol 51 (supplement) ◽

pp. S15-S16

Author(s):

Yosuke Ogura ◽

Asako Sakaue-Sawano ◽

Masashi Nakagawa ◽

Nori Satoh ◽

Atsushi Miyawaki ◽

...

Keyword(s):

Annual Meeting ◽

Neural Tube ◽

Neural Tube Closure ◽

Whole Body ◽

Whole Body Imaging ◽

Body Imaging ◽

Biophysical Society ◽

G2 Phase ◽

Tube Closure

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Whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in prostate cancer: Prevalence and clinical significance of incidental findings

10.21203/rs.3.rs-362544/v1 ◽

2021 ◽

Author(s):

Soma Kumasaka ◽

Shunichi Motegi ◽

Yuka Kumasaka ◽

Tatsuya Nishikata ◽

Masami Otomo ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Incidental Findings ◽

Whole Body ◽

Whole Body Imaging ◽

Resonance Imaging ◽

Body Imaging ◽

Signal Suppression ◽

Body Magnetic Resonance Imaging

Abstract Background Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) is now recommended as a first-line staging modality in prostate cancer patients, and the widespread use of DWIBS may lead to an increased frequency of incidental findings. The aim of this study is to evaluate the prevalence and clinical significance of incidental findings detected on whole-body magnetic resonance imaging (WB-MRI) with DWIBS in patients with prostate cancer. Methods Data from 124 patients (age, 76.5 ± 5.6 years; range, 60–90) with pathologically confirmed prostate cancer, who underwent WB-MRI between December 2016 and April 2020, were retrospectively analyzed. Findings unrelated to prostate cancer were considered as incidental findings and categorized into two groups based on their clinical implications, as follow: imaging follow-up or additional examinations was required (significant incidental findings) and no need to additional work-up (non-significant incidental findings). A Chi-square test was performed to compare the differences in the prevalence of significant incidental findings based on age (≤ 75 and > 75 years old). Results A total of 334 incidental findings were found, with 8.1% (n = 27) as significant incidental findings and 91.9% (n = 307) as non-significant incidental findings. Significant incidental findings were more frequent in patients over 75 years old than those of 75 years old or younger (28.6% vs 11.1%, p = 0.018). Nineteen of the 27 significant incidental findings (70.4%) were observed on non-DWIBS sequences. Conclusion Clinically significant incidental findings, which required imaging follow-up or additional examinations, were commonly observed in patients with prostate cancer on WB-MRI/DWIBS.

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