scholarly journals Role of Magnetic Resonance Imaging in the Management of Patients With Multiple Myeloma: A Consensus Statement

2015 ◽  
Vol 33 (6) ◽  
pp. 657-664 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Jens Hillengass ◽  
Saad Usmani ◽  
Elena Zamagni ◽  
Suzanne Lentzsch ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Magnetic Resonance ◽  
Bone Destruction ◽  
Whole Body ◽  
Focal Lesion ◽  
Resonance Imaging ◽  
Pelvic Mri ◽  
Symptomatic Disease ◽  
Osteoporotic Vertebral Fractures

Purpose The aim of International Myeloma Working Group was to develop practical recommendations for the use of magnetic resonance imaging (MRI) in multiple myeloma (MM). Methods An interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations for the value of MRI based on data published through March 2014. Recommendations MRI has high sensitivity for the early detection of marrow infiltration by myeloma cells compared with other radiographic methods. Thus, MRI detects bone involvement in patients with myeloma much earlier than the myeloma-related bone destruction, with no radiation exposure. It is the gold standard for the imaging of axial skeleton, for the evaluation of painful lesions, and for distinguishing benign versus malignant osteoporotic vertebral fractures. MRI has the ability to detect spinal cord or nerve compression and presence of soft tissue masses, and it is recommended for the workup of solitary bone plasmacytoma. Regarding smoldering or asymptomatic myeloma, all patients should undergo whole-body MRI (WB-MRI; or spine and pelvic MRI if WB-MRI is not available), and if they have > one focal lesion of a diameter > 5 mm, they should be considered to have symptomatic disease that requires therapy. In cases of equivocal small lesions, a second MRI should be performed after 3 to 6 months, and if there is progression on MRI, the patient should be treated as having symptomatic myeloma. MRI at diagnosis of symptomatic patients and after treatment (mainly after autologous stem-cell transplantation) provides prognostic information; however, to date, this does not change treatment selection.

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.

scholarly journals Imaging in multiple myeloma: How? When?

Blood ◽  
2019 ◽  
Vol 133 (7) ◽  
pp. 644-651 ◽  
Author(s):  
Elena Zamagni ◽  
Paola Tacchetti ◽  
Michele Cavo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Multiple Myeloma ◽  
Magnetic Resonance ◽  
Imaging Modality ◽  
Response To Therapy ◽  
Whole Body ◽  
Bone Lesions ◽  
Resonance Imaging ◽  
Pet Ct

Abstract Bone disease is the most frequent feature of multiple myeloma (MM) and represents a marker of end-organ damage; it is used to establish the diagnosis and to dictate the immediate need for therapy. For this reason, imaging plays a significant role in the management of MM patients. Although conventional radiography has traditionally been the standard imaging modality, its low sensitivity in detecting osteolytic lesions and inability to evaluate response to therapy has called for the use of more sophisticated techniques, such as whole-body low-dose computed tomography (WBLDCT), whole-body magnetic resonance imaging, and 18F-fluorodeoxyglucose–positron emission tomography/computed tomography (PET/CT). In this review, the advantages, indications of use, and applications of the 3 techniques in the management of patients with MM in different settings will be discussed. The European Myeloma Network and the European Society for Medical Oncology guidelines have recommended WBLDCT as the imaging modality of choice for the initial assessment of MM-related lytic bone lesions. Magnetic resonance imaging is the gold-standard imaging modality for detection of bone marrow involvement, whereas PET/CT provides valuable prognostic data and is the preferred technique for assessment of response to therapy. Standardization of most of the techniques is ongoing.

scholarly journals Whole-body magnetic resonance imaging for diagnosis and treatment monitoring in multiple myeloma

2020 ◽  
Vol 65 (4) ◽  
pp. 431-443
Author(s):  
N. S. Lutsik ◽  
L. P. Mendeleeva ◽  
M. V. Solovev ◽  
S. M. Kulikov ◽  
Yu. A. Chabaeva ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Whole Body ◽  
Relative Reduction ◽  
Resonance Imaging ◽  
Whole Body Mri ◽  
Adc Values ◽  
Antitumour Response

Introduction. Whole-body diffusion-weighted magnetic resonance imaging (MRI) is an informative method for bone marrow infiltration diagnosis in patients with multiple myeloma (MM) and post-monitoring in autologous haematopoietic stem cell transplantation (auto-HSCT).Aim: to study bone marrow lesions in MM patients using whole-body MRI prior to and after chemotherapy with subsequent auto-HSCT.Materials and methods. Forty patients with MM were included in a prospective study of whole-body MRI before and after high-dose chemotherapy with auto-HSCT. All patients had whole-body MRI prior to and at +100 day of auto-HSCT. Antitumour response was assessed after induction and at +100 day. The number and volume of bone marrow lesions prior to and at +100 day of auto-HSCT were determined, along with apparent diffusion coefficient (ADC) in the lesions.Results. We observed a significant reduction of 29 % in the number of lesions, 40 % — in their volume and 33 % — in ADC. A significant correlation was revealed between relative reduction in the number and volume of foci (r = 0.52, p = 0.0017). A correlation was found between relative reduction in the foci number and ADC (r = 0.47, p = 0.016). Patients with lesions > 7 cm3 in MRI data exhibited a lesser reduction in the foci number and volume and ADC values after auto-HSCT compared to patients with lesions < 7 cm3.Conclusion. Whole-body MRI with diffusion-weighted imaging and subsequent estimation of the number and volume of lesions and their ADC values prior to and after auto-HSCT add power to assessing antitumour response in MM patients with auto-HSCT.

scholarly journals Whole Body Low Dose Computed Tomography (WBLDCT) Can Be Comparable to Whole-Body Magnetic Resonance Imaging (WBMRI) in the Assessment of Multiple Myeloma

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 857
Author(s):  
Davide Ippolito ◽  
Teresa Giandola ◽  
Cesare Maino ◽  
Davide Gandola ◽  
Maria Ragusi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Multiple Myeloma ◽  
Magnetic Resonance ◽  
Low Dose ◽  
Whole Body ◽  
Resonance Imaging ◽  
Lesion Number ◽  
Low Dose Computed Tomography ◽  
Ct And Mri

Aim of the study is to compare the agreement between whole-body low-dose computed tomography (WBLDCT) and magnetic resonance imaging (WBMRI) in the evaluation of bone marrow involvement in patients with multiple myeloma (MM). Patients with biopsy-proven MM, who underwent both WBLDCT and WBMRI were retrospectively enrolled. After identifying the presence of focal bone involvement (focal infiltration pattern), the whole skeleton was divided into five anatomic districts (skull, spine, sternum and ribs, pelvis, and limbs). Patients were grouped according to the number and location of the lytic lesions (<5, 5–20, and >20) and Durie and Salmon staging system. The agreement between CT and MRI regarding focal pattern, staging, lesion number, and distribution was assessed using the Cohen Kappa statistics. The majority of patients showed focal involvement. According to the distribution of the focal lesions and Durie Salmon staging, the agreement between CT and MRI was substantial or almost perfect (all κ > 0.60). The agreement increased proportionally with the number of lesions in the pelvis and spine (κ = 0.373 to κ = 0.564, and κ = 0.469–0.624), while for the skull the agreement proportionally decreased without reaching a statistically significant difference (p > 0.05). In conclusion, WBLDCT showed an almost perfect agreement in the evaluation of focal involvement, staging, lesion number, and distribution of bone involvement in comparison with WBMRI.

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