[Radiological diagnostics of multiple myeloma].

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Context:

• Multiple myeloma diagnosis and staging require accurate assessment of skeletal tumor burden and extraskeletal manifestations.
• Conventional skeletal surveys have limitations in sensitivity for detecting myeloma lesions.
• Advanced imaging modalities offer improved visualization of bone and bone marrow.

Purpose:

• To evaluate the diagnostic performance of whole-body computed tomography (WBCT), 18F-fluorodeoxyglucose positron emission tomography computed tomography (FDG PET-CT), and whole-body magnetic resonance imaging (WBMRI) in multiple myeloma.
• To compare the sensitivity of these advanced techniques against the conventional skeletal survey.
• To provide recommendations for optimal imaging strategies in multiple myeloma.

Summary:

• Whole-body computed tomography (WBCT) and whole-body magnetic resonance imaging (WBMRI) demonstrate higher sensitivity than conventional skeletal surveys for detecting myeloma lesions.
• WBMRI is significantly more sensitive than WBCT for focal lesions and diffuse infiltration; FDG PET-CT offers comparable sensitivity to WBMRI.
• WBCT and WBMRI are recommended to replace the skeletal survey due to their superior detection capabilities.

Impact:

• The findings support the replacement of conventional skeletal surveys with WBCT and WBMRI for more accurate multiple myeloma diagnosis and staging.
• Implementation of these advanced imaging techniques can lead to better assessment of disease burden, fracture risk, and treatment response.
• Clinical guidelines should be updated to incorporate WBCT and WBMRI as preferred modalities for evaluating multiple myeloma.