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Skeletal Survey in Multiple Myeloma: Role of Imaging

[ Vol. 17 , Issue. 8 ]

Author(s):

Paolo Spinnato*, Giacomo Filonzi, Alberto Conficoni, Giancarlo Facchini, Federico Ponti, Andrea Sambri, Massimiliano De Paolis, Michele Cavo, Eugenio Salizzoni and Cristina Nanni   Pages 956 - 965 ( 10 )

Abstract:


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 an accurate evaluation of skeletal disease. The introduction of new high performant imaging tools, such as whole-body lowdose computed tomography, different types of magnetic resonance imaging studies, and 18F-fluorodeoxyglucose positron emission tomography, replaced the 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 the detection of bone marrow involvement, while PET/CT is the preferred technique in the assessment of response to therapy. Both MRI and PET/CT are able to provide prognostic information.

Keywords:

Multiple meloma, bone neoplasm, positron emission tomography computed tomography, magnetic resonance imaging, multidetector computed tomography, image-guided biopsy, hematologic neoplasms.

Affiliation:

Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Department of Radiology, Ospedale Maggiore, Bologna, Neuroradiology Unit, Department of Radiology, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, “Seràgnoli” Institute of Hematology, Bologna University School of Medicine, Bologna, Imaging Division, Clinical Department of Radiological and Histocytopathological Sciences, University of Bologna, Sant’Orsola-Malpighi Hospital, Bologna, Nuclear Medicine, MNM AOU S.Orsola-Malpighi, Bologna

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