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Bones in Multiple Myeloma: Imaging and Therapy.

Elena Zamagni1, Michele Cavo1, Bita Fakhri1

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Advanced imaging techniques like whole-body low-dose CT and FDG-PET/CT are crucial for managing bone disease in multiple myeloma (MM). This review highlights their role alongside new treatments for MM bone disease.

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Area of Science:

  • Oncology
  • Radiology
  • Hematology

Background:

  • Bone disease is a primary clinical feature of multiple myeloma (MM), affecting 90% of patients.
  • Conventional radiography has limitations in detecting osteolytic lesions, necessitating advanced imaging.

Purpose of the Study:

  • To review the advantages, indications, and applications of novel imaging modalities for managing MM bone disease (MMBD).
  • To discuss the current treatment landscape for MMBD, including bisphosphonates and denosumab.

Main Methods:

  • Review of current literature on imaging techniques for MMBD.
  • Discussion of whole-body low-dose CT (WBLDCT), 18F-fluorodeoxyglucose (FDG)-PET/CT, and MRI applications.
  • Overview of MMBD treatment strategies and pharmacologic agents.

Main Results:

  • Advanced imaging modalities offer improved sensitivity for detecting and monitoring MM bone lesions compared to conventional radiography.
  • WBLDCT, FDG-PET/CT, and MRI provide valuable insights into disease extent and activity.
  • Bisphosphonates and denosumab are key therapeutic options for managing MMBD.

Conclusions:

  • Novel imaging plays a pivotal role in the comprehensive management of multiple myeloma patients with bone disease.
  • Integrated imaging and therapeutic strategies are essential for optimizing patient outcomes in MMBD.