Multiple myeloma: 18F-FDG-PET/CT and diagnostic imaging

Area of Science:

• Hematologic Oncology
• Medical Imaging
• Cancer Diagnosis

Background:

• Multiple myeloma (MM) is a rare hematologic malignancy involving plasma cell proliferation, primarily in the bone marrow.
• Extramedullary involvement signifies a poorer prognosis.
• Distinguishing symptomatic MM from precursor plasma cell disorders like monoclonal gammopathy of uncertain significance and smoldering MM is crucial for treatment decisions.

Purpose of the Study:

• To review the diagnostic imaging modalities for multiple myeloma (MM).
• To highlight the role of imaging in staging, treatment response evaluation, and recurrence surveillance.
• To discuss the evolution of staging criteria incorporating advanced imaging.

Main Methods:

• Review of diagnostic imaging procedures used in MM assessment.
• Discussion of conventional radiography, CT, MRI, and radionuclide imaging.
• Emphasis on the integration of (18)F-FDG-PET/CT and MRI into updated staging systems.

Main Results:

• Whole-body X-ray is used for detecting lytic bone lesions, though it has limitations.
• (18)F-FDG-PET/CT is emerging as a preferred radionuclide imaging technique.
• The Durie-Salmon PLUS system incorporates (18)F-FDG-PET/CT and MRI of the spine and pelvis for enhanced staging.

Conclusions:

• Accurate staging of MM is essential for guiding treatment and prognosis.
• Advanced imaging techniques significantly improve the assessment of disease extent and response.
• (18)F-FDG-PET/CT and MRI are integral to modern MM staging and management.