Whole-Body MRI Versus Whole-Body MDCT for Staging of Multiple Myeloma

Baur‐Melnyk, Andrea; Buhmann, Sonja; Becker, Christoph R.; Schoenberg, Stefan O.; Lang, Nicola; Bartl, Reiner; Reiser, Maximilian

doi:10.2214/ajr.07.2635

Cited by 218 publications

(122 citation statements)

References 20 publications

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“…More recently, MRI was included in staging procedures because of its exceptional sensitivity in the detection of tumour spread, especially in the spine [11][12][13][14]. However, MRI is also insensitive for the interim assessment of therapy response [15]. The use of PET in MM started relatively late in comparison to PET in lymphoma.…”

Section: Discussionmentioning

confidence: 99%

Image interpretation criteria for FDG PET/CT in multiple myeloma: a new proposal from an Italian expert panel. IMPeTUs (Italian Myeloma criteria for PET USe)

Nanni

Zamagni

Versari³

et al. 2015

Eur J Nucl Med Mol Imaging

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Purpose FDG PET/CT is able to detect active disease in patients with multiple myeloma (MM) and can be helpful for staging and assessing therapy response, but no standard interpretation criteria have been proposed for the evaluation of FDG PET/CT in MM. Methods A group of Italian nuclear medicine physicians and haematologists met to propose new visual interpretation criteria to standardize FDG PET/CT evaluation in MM patients (Italian Myeloma criteria for PET USe; IMPeTUs) and the reproducibility of these criteria was tested. This Italian multicentre protocol was set up as a subprotocol of EMN02, an international prospective multicentre trial of the European Myeloma Network. The criteria were agreed at multidisciplinary consensus meetings. They include a description of the metabolic state of the bone marrow (BM), number and site of focal PET-positive lesions, the number of osteolytic lesions, and the presence and site of extramedullary disease, paramedullary disease and fractures. A visual degree of uptake was defined for the target lesion and extramedullary lesions according to modified Deauville criteria. MM patients who had undergone FDG PET/CT at baseline (PET-0), after induction (PET-AI) and at the end of treatment (PET-EoT) were enrolled. The patients had been prospectively enrolled in EMN02 and their PET scans were a posteriori reinterpreted in a blinded independent central review process managed by WIDEN®. Five expert nuclear medicine physicians scored the scans according to the new criteria. A case was considered read when four out of the five reviewers completed the report. Concordance among reviewers on different metrics was calculated using Krippendorff's alpha coefficient. Results A total of 17 consecutive patients were enrolled. On PET-0, the alpha coefficients for the BM score, the score for the hottest focal lesion, the number of focal lesions and the number of lytic lesions were 0.33 and 0.47, 0.40 and 0.32, respectively. On PET-AI, the alpha coefficients were 0.09 and 0.43, 0.22 and 0.21, respectively, and on PET-EoT, the alpha coefficients were 0.07, 0.28, 0.25 and 0.21, respectively. BM was generally difficult to score since grades 2 and 3 are difficult to discriminate. However, since neither of the two grades is related to BM myelomatous involvement, the difference was not

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Section: Discussionmentioning

confidence: 99%

Image interpretation criteria for FDG PET/CT in multiple myeloma: a new proposal from an Italian expert panel. IMPeTUs (Italian Myeloma criteria for PET USe)

Nanni

Zamagni

Versari³

et al. 2015

Eur J Nucl Med Mol Imaging

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“…Baur-Melnyk et al 60 found that MRI revealed more extensive disease in half of the patients evaluated when compared with whole-body CT. MRI detected focal plasmacytomas within the marrow before the development of osteolytic changes that were visible by CT or X-ray. [60][61][62] Bannas et al 63 prospectively evaluated 31 patients following ASCT with imaging techniques compared with standard laboratory response criteria. PET/CT had a sensitivity of 50% and a specificity of 85%, and MRI had a sensitivity of 80% and a specificity of 38%.…”

Section: Imagingmentioning

confidence: 99%

Minimal residual disease testing after stem cell transplantation for multiple myeloma

Sherrod

Hari

Mosse

et al. 2015

Bone Marrow Transplant

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“…Magnetic resonance imaging (MRI) is increasingly used in the diagnosis of multiple myeloma, and the recent consensus statement of the International Myeloma Working Group (IMWG) introduced the role of Whole-body Magnetic resonance imaging (WB-MRI) in the management of patients with this haematological disease (3). WB-MRI is recommended in the initial staging of patients with MM due to its high sensitivity in detecting focal lesions or diffuse infiltration of bone marrow, soft tissue injuries, extraosseous lesions as well as for the assessment of treatment response (4).…”

Section: Introduction Introductionmentioning

confidence: 99%

Whole Body MRI Evaluation in Patients with Multiple Myeloma: A Must

Buzoianu¹,

Lupescu²,

Preda³

2017

SGO

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Magnetic resonance imaging (MRI) is increasingly used in the diagnosis of multiple myeloma (MM). The new statement of the International Myeloma Working Group (IMWG) introduced the role of Whole-body Magnetic Resonance Imaging (WB-MRI) in the management of patients with this haematological disease. We report the case of a hospitalized patient in the haematology department, who was diagnosed with MM and investigated by WB-MRI in order to achieve a complete lesions' report, and staging of the disease. The presented case illustrates more lesions of the spine, long bones and the skull. Common MRI characteristics of MM lesions were defined as a nodular injuries, which were hypointense with T1-weighting, hyperintense with STIR and/or hyperintense with b-800 diffusion-weighting. WB-MRI examination was shown to be a sensitive imaging technique in evaluation of bone marrow and it was included in the DurieSalmon staging system PLUS.

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Whole-Body MRI Versus Whole-Body MDCT for Staging of Multiple Myeloma

Abstract: Whole-body MDCT leads to a significantly lower detection rate and staging in patients with multiple myeloma.

Cited by 218 publications

References 20 publications

Image interpretation criteria for FDG PET/CT in multiple myeloma: a new proposal from an Italian expert panel. IMPeTUs (Italian Myeloma criteria for PET USe)

Image interpretation criteria for FDG PET/CT in multiple myeloma: a new proposal from an Italian expert panel. IMPeTUs (Italian Myeloma criteria for PET USe)

Minimal residual disease testing after stem cell transplantation for multiple myeloma

Whole Body MRI Evaluation in Patients with Multiple Myeloma: A Must

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