Myeloma bone and extra-medullary disease: Role of PET/CT and other whole-body imaging techniques. (May 2016)

• Record Type: Journal Article
• Authors: Rubini, Giuseppe; Niccoli-Asabella, Artor; Ferrari, Cristina; Racanelli, Vito; Maggialetti, Nicola; Dammacco, Francesco
• Is Part Of: Critical reviews in oncology/hematology. Volume 101(2016)
• Page Start: 169
• Page End: 183
• Publication Date: 2016-05
• Subjects: [11C]CHO [11C]Choline -- [11C]MET [11C]Methionine -- [18F]FDG-PET/CT 2-deoxy-2-[18F]fluoro-d-glucose-positron emission tomography/computed tomography -- [18F]FLT 3′-[18F]fluoro-3′-deoxy-l-thymidine -- [18F]NaF [18F]sodium-fluoride -- [99mTc]MDP [99mtechnetium]methylene-diphosphonate -- [99mTc]sestaMIBI 2-methoxy-isobutyl-isonitrile[99mTc]technetium -- ASCT autologous hematopoietic stem cell transplantation -- BS bone scintigraphy -- CRAB hyper-calcemia, renal involvement, anemia, lytic bone lesions -- FoV field of view -- GLUT glucose transporter -- IMWG International Myeloma Working Group -- MGUS monoclonal gammopathy of undetermined significance -- MM multiple myeloma -- MRD minimal residual disease -- MTV metabolic tumor volume -- OS overall survival -- PFS progression free survival -- PPV positive predictive value -- SBP solitary bone plasmacytoma -- SMM smoldering multiple myeloma -- STIR short time inversion recovery -- SUVmax maximum standardized uptake value -- T1w T1-weighted -- T2w T2-weighted -- TLG total lesion glycolysis -- TTP time to progression -- WB-LDCT whole body low dose computed tomography -- WB-MDCT whole body multidetector computed tomography -- WB-MR whole body magnetic resonance -- WB-MR/DWIBS WB-MR/diffusion-weighted imaging with background body signal suppression -- WB-XR whole body skeletal X-ray; Bone disease -- Diffusion weighted whole body imaging with background body signal suppression (DWIBS) -- Multiple myeloma -- Positron emission tomography/computed tomography (PET/CT) -- Positron emission tomography/magnetic resonance (PET/MR) -- Whole body magnetic resonance (WB-MR); Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2016.03.006
• Languages: English
• ISSNs: 1040-8428

Abstract

Abstract: Multiple myeloma (MM) is the second most common hematological malignancy. Although it can affect different organs, the bone compartment stands out both in terms of prevalence and clinical impact. Despite the striking advances in MM therapy, bone disease can remarkably affect the patient's quality of life. The occurrence and extension of bone marrow and extra-medullary involvement should be carefully assessed to confirm the diagnosis, to locate and whenever possible prevent dreadful complications such as pathological fractures and spinal cord compression, and to establish suitable therapeutic measures. Many imaging techniques have been proposed for the detection of MM skeletal involvement. With the development of more sophisticated imaging tools, it is time to use the right technique at the right time. Based on the review of the literature and our own experience, this article discusses advantages and disadvantages of the different imaging methods in the work-up of MM patients, with particular emphasis on the role that PET/CT can play. It is emphasized that whole body low-dose computed tomography should be the preferred imaging technique at baseline. However, bone marrow infiltration and extra-medullary manifestations are better detected by whole body magnetic resonance imaging. Positron emission tomography/computed tomography, on the other hand, combines the benefits of the two mentioned imaging procedures and is particularly useful not only for the detection of osteolytic lesions unrevealed by conventional X-ray, but also in the assessment of prognosis and therapeutic response.