The Role of Imaging in the Treatment of Patients With Multiple Myeloma in 2016

2016 ◽  
pp. e407-e417 ◽  
Author(s):  
Evangelos Terpos ◽  
Meletios A. Dimopoulos ◽  
Lia A. Moulopoulos
Keyword(s):  
Multiple Myeloma ◽  
Residual Disease ◽  
Conventional Radiography ◽  
Whole Body ◽  
Imaging Method ◽  
Whole Body Mri ◽  
Pet Ct ◽  
Lytic Lesions ◽  
Solitary Bone Plasmacytoma ◽  
Work Up

The novel criteria for the diagnosis of symptomatic multiple myeloma have revealed the value of modern imaging for the management of patients with myeloma. Whole-body low-dose CT (LDCT) has increased sensitivity over conventional radiography for the detection of osteolytic lesions, and several myeloma organizations and institutions have suggested that whole-body LDCT should replace conventional radiography for the work-up of patients with myeloma. MRI is the best imaging method for the depiction of marrow infiltration by myeloma cells. Whole-body MRI (or at least MRI of the spine and pelvis if whole-body MRI is not available) should be performed for all patients with smoldering multiple myeloma with no lytic lesions to look for occult disease, which may justify treatment. In addition, MRI accurately illustrates the presence of plasmacytomas, spinal cord, and/or nerve compression for surgical intervention or radiation therapy; it is also recommended for the work-up of solitary bone plasmacytoma, and it may distinguish malignant from benign fractures (which is very important in cases of patients in biochemical remission with no other signs of progression). Diffusion weighted imaging (DWI) seems to improve MRI diagnosis in patients with myeloma. PET/CT is a functional imaging technique, more sensitive than conventional radiography for the detection of lytic lesions, which probably allows better definition of complete response and minimal residual disease compared with all other imaging methods. PET/CT has shown the best results in the follow-up of patients with myeloma and has an independent prognostic value both at diagnosis and following treatment. PET/CT can also be used for the work-up of solitary bone plasmacytoma and nonsecretory myeloma.

Whole-body MRI and PET/CT in multiple myeloma patients during staging and after treatment: personal experience in a longitudinal study

2013 ◽  
Vol 118 (6) ◽  
pp. 930-948 ◽  
Author(s):  
Giuseppe Lucio Cascini ◽  
Carmela Falcone ◽  
Domenico Console ◽  
Antonino Restuccia ◽  
Marco Rossi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Longitudinal Study ◽  
Personal Experience ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pet Ct

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.

Diagnostic performance of 18F-FDG PET/CT and whole-body MRI before and early after treatment of multiple myeloma: a prospective comparative study

2018 ◽  
Vol 36 (6) ◽  
pp. 382-393 ◽  
Author(s):  
Mohammad Abd Alkhalik Basha ◽  
Maged Abdel Gelil Hamed ◽  
Rania Refaat ◽  
Mohamad Zakarya AlAzzazy ◽  
Manar A. Bessar ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Comparative Study ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pet Ct ◽  
Prospective Comparative Study ◽  
18F Fdg ◽  
Fdg Pet Ct

Pictorial review of multiple myeloma on whole-body MRI and PET-CT

2019 ◽  
Vol 74 ◽  
pp. e16
Author(s):  
Md Ziaul Haque ◽  
Syed Tauseef Ashraf ◽  
Sabrina Alam
Keyword(s):  
Multiple Myeloma ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pictorial Review ◽  
Pet Ct

scholarly journals Imaging of treatment response and minimal residual disease in multiple myeloma: state of the art WB-MRI and PET/CT

2021 ◽  
Author(s):  
Frederic E. Lecouvet ◽  
Marie-Christiane Vekemans ◽  
Thomas Van Den Berghe ◽  
Koenraad Verstraete ◽  
Thomas Kirchgesner ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Minimal Residual Disease ◽  
Fdg Pet ◽  
Residual Disease ◽  
Whole Body ◽  
Bone Lesions ◽  
Next Generation ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Minimal Residual

AbstractBone imaging has been intimately associated with the diagnosis and staging of multiple myeloma (MM) for more than 5 decades, as the presence of bone lesions indicates advanced disease and dictates treatment initiation. The methods used have been evolving, and the historical radiographic skeletal survey has been replaced by whole body CT, whole body MRI (WB-MRI) and [18F]FDG-PET/CT for the detection of bone marrow lesions and less frequent extramedullary plasmacytomas.Beyond diagnosis, imaging methods are expected to provide the clinician with evaluation of the response to treatment. Imaging techniques are consistently challenged as treatments become more and more efficient, inducing profound response, with more subtle residual disease. WB-MRI and FDG-PET/CT are the methods of choice to address these challenges, being able to assess disease progression or response and to detect “minimal” residual disease, providing key prognostic information and guiding necessary change of treatment.This paper provides an up-to-date overview of the WB-MRI and PET/CT techniques, their observations in responsive and progressive disease and their role and limitations in capturing minimal residual disease. It reviews trials assessing these techniques for response evaluation, points out the limited comparisons between both methods and highlights their complementarity with most recent molecular methods (next-generation flow cytometry, next-generation sequencing) to detect minimal residual disease. It underlines the important role of PET/MRI technology as a research tool to compare the effectiveness and complementarity of both methods to address the key clinical questions.

The utility of ADC value in diffusion-weighted whole-body MRI in the follow-up of patients with multiple myeloma. Correlation study with 18F-FDG PET-CT

2020 ◽  
Vol 133 ◽  
pp. 109403
Author(s):  
Alberto Paternain ◽  
María José García-Velloso ◽  
Juan José Rosales ◽  
Ana Ezponda ◽  
Ignacio Soriano ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Fdg Pet ◽  
Correlation Study ◽  
Whole Body ◽  
Adc Value ◽  
Whole Body Mri ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Whole-body MRI and PET/CT in patients with multiple myeloma: the need for a combined use

2010 ◽  
Vol 10 (1A) ◽  
pp. S50-S50
Author(s):  
G.L. Cascini ◽  
C. Falcone ◽  
A. Restuccia ◽  
C. Alessi ◽  
O. Tamburrini
Keyword(s):  
Multiple Myeloma ◽  
Whole Body ◽  
Whole Body Mri ◽  
Combined Use ◽  
Pet Ct

Multiple Myeloma Guidelines and Their Recent Updates: Implications for Imaging

2019 ◽  
Vol 191 (11) ◽  
pp. 998-1009
Author(s):  
Jennifer Mosebach ◽  
Heidi Thierjung ◽  
Heinz-Peter Schlemmer ◽  
Stefan Delorme
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Residual Disease ◽  
Imaging Techniques ◽  
Bone Marrow Involvement ◽  
Whole Body ◽  
Bone Lesions ◽  
Cross Sectional ◽  
Symptomatic Disease ◽  
Pet Ct

Background In 2014, the diagnostic criteria for multiple myeloma were updated, leading to revised recommendations for imaging modalities and definition of therapy response. This review provides an overview of the current definitions of monoclonal plasma cell disease, diagnostic options, and changes relevant to radiologists. Method A pubmed search regarding the multiple myeloma guidelines was conducted, and results were filtered considering publications of international associations and expert reviews. Recommendations by the International Myeloma Working Group (IMWG), the National Comprehensive Cancer Network (NCCN, USA), the European Society for Medical Oncology (ESMO), and the European Myeloma Network are acknowledged. Results and Conclusion Conventional skeletal survey is to be replaced by cross-sectional imaging techniques. For initial diagnostics of bone lesions or bone marrow involvement defining multiple myeloma, whole-body low-dose CT and whole-body MRI are recommended. Two or more focal bone marrow lesions suspicious for myeloma on MRI will now define symptomatic disease even in the case of intact mineralized bone. Follow-up imaging is not clearly specified so far. New guidelines concerning the definitions of minimal residual disease include the assessment of focal lesions before and after treatment using 18F-FDG-PET/CT, with the potential to redefine the role of PET/CT in the diagnostics of multiple myeloma. Key points:  Citation Format

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