Skip to main content
SpringerLink
Log in

Role of 18F-FDG PET/CT in the assessment of bone involvement in newly diagnosed multiple myeloma: preliminary results

  • Original article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Multiple myeloma (MM) is a malignant B cell and plasma cell disorder which involves the skeleton in more than 80% of patients at diagnosis. The aim of this study was to compare whole-body X-ray (WBXR), MRI and 18F-FDG PET/CT in patients with MM.

Methods

The study population comprised 28 newly diagnosed MM patients. Findings of 18F-FDG PET/CT were compared with those of WBXR and MRI with regard to the number and site of lesions detected.

Results

Comparing 18F-FDG PET/CT and WBXR, it was found that in 16/28 pts (57%) 18F-FDG PET/CT detected more lesions, all of which were located in the skeleton. Nine of these 16 patients had a completely negative WBXR survey. In 12/28 pts (43%) the two methods yielded equivalent findings. Comparing 18F-FDG PET/CT and MRI, it was found that in 7/28 pts (25%), 18F-FDG PET/CT detected more lytic bone lesions, all of which were located outside the field of view of MRI (bone lesions in six cases and a soft tissue lesion in one). In 14/28 pts (50%), 18F-FDG PET/CT and MRI detected the same number of lesions in the spine and pelvis, while in 7/28 pts (25%) MRI detected an infiltrative pattern in the spine whereas 18F-FDG PET/CT was negative.

Conclusion

18F-FDG PET/CT appears to be more sensitive than WBXR for the detection of small lytic bone lesions, whereas it has the same sensitivity as MRI in detecting bone disease of the spine and pelvis. On the other hand, MRI may be superior to 18F-FDG PET/CT in diagnosing an infiltrative pattern in the spine. Therefore, careful evaluation of MM bone disease at diagnosis should include both MRI of the spine and 18F-FDG PET/CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bataille R, Harousseau JL. Multiple myeloma. N Engl J Med 1997;336:1657–1664

    Article  PubMed  CAS  Google Scholar 

  2. Bataille R, Manolagas SC, Berenson JR. Pathogenesis and management of bone lesions in multiple myeloma. Hematol Oncol Clin North Am 1997;11:349–361

    Article  PubMed  CAS  Google Scholar 

  3. Terpos E, Politou M, Rahemtulla A. New insights into the pathophysiology and management of bone disease in multiple myeloma. Br J Haematol 2003;123:758–769

    Article  PubMed  CAS  Google Scholar 

  4. Mitsiades CS, Mitsiades N, Munshi NC, Anderson KC. Focus on multiple myeloma. Cancer Cell 2004;6:439–444

    Article  PubMed  CAS  Google Scholar 

  5. Jemal A, Thomas A, Nurray T, Thun M. Cancer statistics 2002. CA Cancer J Clin 2002;52:23–47

    Article  PubMed  Google Scholar 

  6. Blade J, Kyle RA, Greipp PR. Multiple myeloma in patients younger than 30 years: report of 10 cases and review of the literature. Arch Intern Med 1996;156:1463–1468

    Article  PubMed  CAS  Google Scholar 

  7. Hallek M, Bergsagel PF, Anderson KC. Multiple myeloma: increasing evidence for a multistep transformation process. Blood 1998;91:3–21

    PubMed  CAS  Google Scholar 

  8. Klein B, Bataille R. Cytokine network in human multiple myeloma. Hematol Oncol Clin North Am 1992;6:273–284

    PubMed  CAS  Google Scholar 

  9. Schwartz GG. Multiple myeloma: clusters, clues, and dioxins. Cancer Epidemiol Biomarkers Prev 1997;6:49–56

    PubMed  CAS  Google Scholar 

  10. Lecouvet FE, Malghem J, Michaux L, Maldague B, Ferrant A, Michaux JL, et al. Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol 1999;106:35–39

    Article  PubMed  CAS  Google Scholar 

  11. Umeda M, Adachi Y, Tomiyama J, Takasaki M, Shin K, Mori M, et al. Bone lesions in elderly multiple myeloma. Nippon Ronen Igakkai Zasshi 2002;39:631–638

    PubMed  Google Scholar 

  12. Kitano M, Ogata A, Sekiguchi M, Hamano T, Sano H. Biphasic anti-osteoclastic action of intravenous alendronate therapy in multiple myeloma bone disease. J Bone Miner Metab 2005;23:48–52

    Article  PubMed  Google Scholar 

  13. Harousseau JL, Shaughnessy J Jr, Richardson P. Multiple myeloma. Hematology (Am Soc Hematol Educ Program) 2004;237–256

  14. Woodruff RK, Wadsworth J, Malpas JS, Tobias JS. Clinical staging in multiple myeloma. Br J Haematol 1979;42:199–205

    PubMed  CAS  Google Scholar 

  15. Durie BG, Kyle RA, Belch A, Bensinger W, Blade J, Boccadoro M, et al. Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation. Haematol J 2003;4:379–398

    Google Scholar 

  16. Durie BG, Salmon SE. A clinical staging system for multiple myeloma: correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. Cancer 1975;36:842–854

    Article  PubMed  CAS  Google Scholar 

  17. Angtuaco EJ, Fassas AB, Walker R, Sethi R, Barlogie B. Multiple myeloma: clinical review and diagnostic imaging. Radiology 2004;231:11–23

    Article  PubMed  Google Scholar 

  18. Walker RE, Eustace SJ. Whole-body magnetic resonance imaging: techniques, clinical indications and future applications. Semin Musculoskelet Radiol 2001;5:5–19

    Article  PubMed  CAS  Google Scholar 

  19. Vogler JB, Murphy WA. Bone marrow imaging. Radiology 1988;168:679–693

    PubMed  Google Scholar 

  20. Weinreb JC. MR imaging of bone marrow. Radiology 1990;177:23–24

    PubMed  CAS  Google Scholar 

  21. Tertti R, Alanen A, Remes K. The value of magnetic resonance imaging in screening myeloma lesions of the lumbar spine. Br J Haematol 1995;91:658–660

    PubMed  CAS  Google Scholar 

  22. Ghanema N, Uhla M, Brink IB, Schaeer O, Kelly T, Moser E, et al. Diagnostic value of MRI in comparison to scintigraphy, PET, MS-CT and PET/CT for the detection of metastases of bone. Eur J Radiol 2005;55:41–55

    Article  Google Scholar 

  23. Schmidt GP, Schoenberg SO, Reiser MF, Baur-Melnyk A. Whole-body MR imaging of bone marrow. Eur J Radiol 2005;55:33–40

    Article  PubMed  CAS  Google Scholar 

  24. Baur-Melnyk A, Reiser M. [Staging of multiple myeloma with MRI: comparison to MSCT and conventional radiography]. Radiologe 2004;44:874–881

    Article  PubMed  CAS  Google Scholar 

  25. Moulopoulos LA, Varma DG, Dimopoulos MA, Leeds NE, Kim EE, Johnston DA, et al. Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease. Radiology 1992;185:833–840

    PubMed  CAS  Google Scholar 

  26. Baur A, Stabler A, Nagel D, Lamerz R, Bartl R, Hiller E, et al. Magnetic resonance imaging as a supplement for the clinical staging system of Durie and Salmon? Cancer 2002;95:1334–1345

    Article  PubMed  Google Scholar 

  27. Moulopolous LA, Dimopoulos MA. Magnetic resonance imaging of the bone marrow in hematologic malignancies. Blood 1997;90:2127–2147

    Google Scholar 

  28. Moulopoulos LA, Dimopoulos MA, Smith T, Weber D, Delasalle KB, Libshitz HI, et al. Prognostic significance of magnetic resonance imaging in patients with asymptomatic multiple myeloma. J Clin Oncol 1995;13:251–256

    PubMed  CAS  Google Scholar 

  29. Moulopoulos LA, Gika D, Anagnostopoulos A, Delasalle K, Weber D, Alexanian R, Dimopoulos MA.Prognostic significance of magnetic resonance imaging of bone marrow in previously untreated patients with multiple myeloma.Ann Oncol 2005;16:1824–1828

    Article  PubMed  CAS  Google Scholar 

  30. Mariette X, Zagdanski AM, Guermazi A, Bergot C, Arnould A, Frija J, et al. Prognostic value of vertebral lesions detected by magnetic resonance imaging in patients with stage I multiple myeloma. Br J Haematol 1999;104:723–729

    Article  PubMed  CAS  Google Scholar 

  31. Lecouvet FE, Malghem J, Michaux L, Maldague B, Ferrant A, Michaux JL, et al. Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol 1999;106:35–39

    Article  PubMed  CAS  Google Scholar 

  32. Moulopolous LA, Dimopoulos MA, Alexanian R, Leeds NE, Libshitz HI. Multiple myeloma: MR patterns of response to treatment. Radiology 1994;193:441–446

    Google Scholar 

  33. Jadvar H, Conti PS. Diagnostic utility of FDG PET in multiple myeloma. Skeletal Radiol 2002;31:690–694

    Article  PubMed  Google Scholar 

  34. Schirrmeister H, Bommer M, Buck AK, Muller S, Messer P, Bunjes D, et al. Initial results in the assessment of multiple myeloma using FDG-PET. Eur J Nucl Med 2002;29:361–366

    Article  CAS  Google Scholar 

  35. Durie GM, Waxman AD, D’Agnolo A, Williams CM. Whole body 18F-FDG-PET identifies high-risk myeloma. J Nucl Med 2002;43:1457–1463

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. UO Medicina Nucleare, Policlinico S.Orsola-Malpighi, Via Massarenti, 40100, Bologna, Italy

    Cristina Nanni, Mohsen Farsad, Paolo Castellucci & Stefano Fanti

  2. Istituto di Ematologia, Policlinico S.Orsola-Malpighi,, Bologna, Italy

    Elena Zamagni, Patrizia Tosi, Delia Cangini & Michele Cavo

  3. Istituto di Radiologia, Policlinico S.Orsola-Malpighi,, Bologna, Italy

    Eugenio Salizzoni & Romeo Canini

Authors
  1. Cristina Nanni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Zamagni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohsen Farsad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paolo Castellucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Patrizia Tosi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Delia Cangini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eugenio Salizzoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Romeo Canini
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Michele Cavo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Stefano Fanti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefano Fanti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nanni, C., Zamagni, E., Farsad, M. et al. Role of 18F-FDG PET/CT in the assessment of bone involvement in newly diagnosed multiple myeloma: preliminary results. Eur J Nucl Med Mol Imaging 33, 525–531 (2006). https://doi.org/10.1007/s00259-005-0004-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-005-0004-3

Keywords

Search

Navigation