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

Elena Zamagni, Cristina Nanni, Francesca Patriarca, Emanuela Englaro, Paolo Castellucci, Onelio Geatti, Patrizia Tosi, Paola Tacchetti, Delia Cangini, Giulia Perrone, Michela Ceccolini, Annamaria Brioli, Silvia Buttignol, Renato Fanin, Eugenio Salizzoni, Michele Baccarani, Stefano Fanti, Michele Cavo

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives: Bone lesions in multiple myeloma (MM) have been traditionally detected by whole body X-ray (WBXR) survey although magnetic resonance imaging (MRI) has become the gold standard for detecting MM involvement of the spine and pelvis. The aim of this study was to compare a new technique, positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) integrated with computed tomography (18F-FDG PET-CT), with MRI and WBXR for baseline assessment of bone disease in MM. Design and Methods: We prospectively compared 18F-FDG PET-CT, MRI of the spine-pelvis and WBXR for baseline assessment of bone disease in a series of 46 patients with newly diagnosed MM. In 23 patients who received up front autologous transplantation, we also compared post-treatment PET-CT scans with MR images of the spine and pelvis. Results: Overall, PET-CT was superior to planar radiographs in 46% of patients, including 19% with negative WBXR. In 30% of patients, PET-CT scans of the spine and pelvis failed to show abnormal findings in areas in which MRI revealed an abnormal pattern of bone marrow involvement, more frequently of diffuse type. In contrast, in 35% of patients PET-CT enabled the detection of myelomatous lesions in areas which were out of the field of view of MRI. By combining MRI of the spine-pelvis and 18F-FDG PET-CT, the ability to detect sites of active MM, both medullary and extramedullary, was as high as 92%. Following transplantation, 15 patients had negative PET-CT scans (including 13 with a very good partial response or at least near complete response), but only 8 had normal MRI. Interpretation and Conclusions: MRI of the spine and pelvis still remains the gold standard imaging technique for the detection of bone marrow involvement in MM. 18F-FDG PET-CT provides additional and valuable information for the assessment of myeloma bone disease in areas not covered by MRI.

Original languageEnglish
Pages (from-to)50-55
Number of pages6
JournalHaematologica
Volume92
Issue number1
DOIs
Publication statusPublished - Jan 2007

Keywords

  • F-fluorodeoxyglucose positron emission tomography-computed tomography
  • Bone disease
  • Magnetic resonance imaging
  • Multiple myeloma
  • Whole-body planar radiographs

ASJC Scopus subject areas

  • Hematology

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