Agreement Between 18F-FDG PET/CT and Whole-Body Magnetic Resonance Compared With Skeletal Survey for Initial Staging and Response at End-of-Treatment Evaluation of Patients With Multiple Myeloma

Abstract

Purpose To compare the agreement between whole-body (WB) magnetic resonance (MR) imaging, 18 F-FDG PET/CT, and skeletal survey (SS) in patients with multiple myeloma (MM) for diagnosis, initial staging, response evaluation, and early detection of complications. Methods This is a retrospective cohort study including MM patients who were diagnosed, treated, and followed in 2 institutions. These patients were studied with SS, WB-MR, and/or 18 F-FDG PET/CT. We studied bone lesions by anatomical locations and analyzed the concordance between SS and a tomographic technique (WB-MR or 18 F-FDG PET/CT) and between both tomographic techniques (WB-MR and PET/CT). Results Forty-four MM patients with a mean age of 62.6 years (range, 38–85 years) were included from January 2012 to February 2016. Whole-body MR and 18 F-FDG PET/CT found more lesions than SS in every location except in the skull. Concordance between WB-MR and 18 F-FDG PET/CT was either good or excellent in most of the locations and in plasmacytoma studies. However, WB-MR was better than 18 F-FDG PET/CT in the study of complications (medullar compression and vascular necrosis). Conclusions Our results suggest the study of MM patients should include WB-MR and/or 18 F-FDG PET/CT, whereas SS is only useful for the skull. Whole-body MR and 18 F-FDG PET/CT are complementary techniques, because both of them show good concordance in almost every location. It is still necessary to individualize the indication of each technique according to patient characteristics.

Radiotherapy alleviates spinal cord compression caused by solitary bone plasmacytoma: A case report

“…(6) No additional lesions on MRI scan of the spine. According to the consensus statement and guidelines from the International Myeloma Working Group, to better assess both the extent of the local tumor and the revealing of occult lesions elsewhere, MRI is recommended in all patients with an SPB and helpful in the initial staging of SBP [17] , [18] .…”

Metabolic Volume Measurements in Multiple Myeloma

“…They allow the assessment of the effects of the disease on the skeletal system and identify the presence of extramedullary disease. In the past, this included skeletal radiographic examinations, now largely replaced by CT, MRI and FDG-PET/CT [83][84][85][86][87].…”

“…Other studies also support the concept that MRI and FDG-PET/CT are complementary techniques. [7,86,[94][95][96][97].…”

Ovarian Metastasis From Diffuse Epithelioid Malignant Mesothelioma Revealed by 18F-FDG PET/CT

“…Distant metastases most commonly occur in the liver (31.9%), spleen (10.8%), thyroid gland (6.9%), and brain (3.0%), 2 whereas the metastasis of diffuse epithelioid MM to the ovary is rare. FDG PET/CT represents the principal metabolic imaging modality for oncological assessment 3–9 . Its role is recognized for the majority of clinical indications, comprising staging and restaging MM 3,10 .…”