Title:Skeletal Survey in Multiple Myeloma: Role of Imaging
Volume: 17
Author(s): Paolo Spinnato*, Giacomo Filonzi, Alberto Conficoni, Giancarlo Facchini, Federico Ponti, Andrea Sambri, Massimiliano De Paolis, Michele Cavo, Eugenio Salizzoni and Cristina Nanni
Affiliation:
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna,Italy
Keywords:
Multiple meloma, bone neoplasm, positron emission tomography computed tomography, magnetic resonance imaging,
multidetector computed tomography, image-guided biopsy, hematologic neoplasms.
Abstract:
Bone disease is the hallmark of multiple myeloma. Skeletal lesions are evaluated to
establish the diagnosis, to choose the therapies and also to assess the response to treatments. Due to
this, imaging procedures play a key role in the management of multiple myeloma.
For decades, conventional radiography has been the standard imaging modality. Subsequently, advances
in the treatment of multiple myeloma have increased the need for an accurate evaluation of
skeletal disease. The introduction of new high performant imaging tools, such as whole-body lowdose
computed tomography, different types of magnetic resonance imaging studies, and 18F-fluorodeoxyglucose
positron emission tomography, replaced the conventional radiography.
In this review, we analyze the diagnostic potentials, indications of use, and applications of the imaging
tools nowadays available.
Whole-body low-dose CT should be considered as the imaging modality of choice for the initial assessment
of multiple myeloma lytic bone lesions. MRI is the gold-standard for the detection of
bone marrow involvement, while PET/CT is the preferred technique in the assessment of response
to therapy. Both MRI and PET/CT are able to provide prognostic information.
