Abstract
Purpose
Diagnostic imaging plays a pivotal role in staging and prognostic assessment of multiple myeloma (MM) as well as planning and monitoring treatment. The aim of our study was to estimate the diagnostic accuracy of wholebody magnetic resonance imaging (WB-MRI) and positron emission tomography/computed tomography (PET/CT) in MM patients studied before and after treatment.
Materials and methods
We considered 22 consecutive patients (10 males, 12 females; age range, 48–83 years) with newly diagnosed MM (NDMM group), and the same 22 patients underwent at least one re-assessment after treatment (previously treated MM, PTMM group). WBMRI and PET/CT were performed within days from each other in both the NDMM (22 studies) and PTMM (29 studies) group. The imaging findings were compared to the results of bone marrow aspiration.
Results
PET/CT was positive in 18/22 NDMM patients, whereas WB-MRI correctly identified 100% of patients. Of 20 responder patients in the PTMM group, 16 were negative at PET/CT and 12/20 at MRI. By contrast, of the nine nonresponder patients, MRI correctly detected active disease in all cases, and PET only in seven.
Conclusions
WB-MRI proved superior to PET/CT in detecting MM, especially in diffuse disease. PET/CT appears to be more sensitive in the assessment of MM after treatment.
Riassunto
Obiettivo
La diagnostica per immagini svolge un ruolo centrale nella stadiazione, nella definizione prognostica oltre che nella pianificazione e nel monitoraggio della terapia in pazienti con mieloma multiplo (MM). Scopo del nostro studio è stato valutare l’accuratezza diagnostica della whole body (WB)-risonanza magnetica (RM) e della tomografia computerizzata (TC)/tomografia ad emissione di positroni (PET) in pazienti con MM prima e dopo trattamento.
Materiali e metodi
Sono stati arruolati 22 pazienti consecutivi (10 maschi e 12 femmine, di età compresa tra 44 e 83 anni) alla diagnosi (gruppo NDMM). Gli stessi pazienti sono stati valutati longitudinalmente dopo trattamento (gruppo PTMM). WB-RM e TC/PET sono state effettuate a breve distanza tra loro sia nel gruppo NDMM (22 esami) che nel gruppo PTMM (29 esami). I risultati dell’imaging sono stati infine correlati all’aspirato midollare. Risultati. Nel gruppo NDMM la TC/PET è risultata positiva i 18/22 pazienti, mentre la WB-RM nel 100%. Nel gruppo PTMM 20 pazienti responsivi dopo terapia, 16 risultavano negativi alla TC/PET, mentre 12 negativi all’RM. Al contrario nei 9 pazienti non-responsivi risultavano positivi tutti all’RM e 7 alla TC/PET.
Conclusioni
La WB-RM è risultata superiore alla TC/PET con fluor-deossiglucosio nella diagnosi di malattia specie se diffusa, mentre la TC/PET appare più sensibile dopo trattamento.
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Cascini, G.L., Falcone, C., Console, D. et al. Whole-body MRI and PET/CT in multiple myeloma patients during staging and after treatment: personal experience in a longitudinal study. Radiol med 118, 930–948 (2013). https://doi.org/10.1007/s11547-013-0946-7
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DOI: https://doi.org/10.1007/s11547-013-0946-7