Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease.

Abstract

Spinal magnetic resonance (MR) imaging was performed in 29 patients with newly diagnosed, untreated multiple myeloma. Nineteen (66%) patients were asymptomatic. Sagittal pre- and postcontrast T1-weighted spin-echo images and gradient-recalled-echo images of the thoracic and lumbosacral spine were obtained. Marrow involvement was identified in 20 (69%) patients. There were three MR patterns: focal lesions in nine patients (31%), diffuse involvement in seven (24%), and an inhomogeneous pattern of tiny lesions on a background of normal marrow in four (14%). A statistically significant correlation between MR imaging patterns of marrow involvement and serum hemoglobin values (one-way, P = .0899; Kruskal-Wallis, P = .0620) and between MR imaging patterns and percentage of marrow plasmacytosis (Kruskal-Wallis, P = .0314) was noted, with patterns of diffuse and focal marrow involvement associated with more abnormal values. Spinal MR imaging in patients with early myeloma may reveal marrow involvement in both symptomatic and asymptomatic patients. Some correlation was found between MR imaging patterns and laboratory indexes of disease.

A prospective comparison of 18F-fluorodeoxyglucose positron emission tomography-computed tomography, magnetic resonance imaging and whole-body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma

“…Thus, MRI of the spine and pelvis was more sensitive and specific than PET-CT, particularly among patients lacking a focal MR bone marrow pattern. On the basis of these results, which resemble those of previously published studies, 22,24 and in the light of the adverse prognostic relevance of an abnormal diffuse MR pattern of the spine, 18 it can be concluded that MRI still remains the gold standard technique for the detection of bone marrow involvement of the spine and pelvis.…”

“…They independently evaluated the bone marrow infiltration and, on the basis of previously reported criteria, identified the following patterns of bone marrow involvement: normal, focal and diffuse. 18 In the case of focal pattern, the exact number and site of lesions were reported. WBXR survey included plain radiographs of the skull, spine, pelvis, ribs, femora and humeri.…”

“…Response criteria were those proposed by Bladè et al, 18 with the addition of a near complete response category, as identified by disappearance of M protein on routine electrophoresis, but positive immunofixation. Criteria used for evaluation of MRI following therapy were previously reported; 20 in particular, complete response included resolution of marrow abnormality or persistent abnormality without enhancement, whereas a decrease in the amount of marrow abnormality with persistent enhancement were considered a partial response.…”

Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

“…Infiltration of the bone marrow by myeloma has been described previously as broad categories of focal, patchy/variegated, or diffuse infiltration. [16][17][18][19][20][21][22] The current study describes a semiquantitative way to assess bone marrow infiltration by MRI that may be more reproducible.…”

The role of 18F-FDG PET/CT before and after the treatment of multiple myeloma: Our clinical experience

“…In summary, in the most recent studies, the pathological FDG uptake is characterized by SUVmax (with a cut-off value 2.5 and/ or 4.2) and only the PET positive and PET negative groups are created; therefore, we also analysed the data in the same way in our study. Several studies have shown that an MRI is more sensitive than a whole-body X-ray for the detection of bone involvement in MM [21][22][23] . In 2013, a meta-analysis confirmed the superiority of MRI over wholebody Xray, mainly in the axial skeleton [3,24] .…”