ABSTRACT
Myeloma is the most common primary bone malignancy and one of the most common hematologic
malignancies. Research on myeloma constantly produces new information on genetic factors,
imaging techniques, and treatment complications among others that is of use to patients,
referring physicians, and radiologists. This update emphasizes new developments regarding
imaging techniques for diagnosis, staging, and follow-up of myeloma patients. Advances
in whole body radiography, whole body computed tomography, whole body magnetic resonance
imaging, and whole body nuclear techniques (including sestamibi and positron emission
tomography) are discussed.
KEYWORDS
Myeloma - imaging - computed tomography - magnetic resonance imaging - positron emission
tomography
REFERENCES
- 1
Alexander D D, Mink P J, Adami H O et al..
Multiple myeloma: a review of the epidemiologic literature.
Int J Cancer.
2007;
120(Suppl 12)
40-61
- 2
Corre J, Mahtouk K, Attal M et al..
Bone marrow mesenchymal stem cells are abnormal in multiple myeloma.
Leukemia.
2007;
21
1079-1088
- 3
Shaughnessy J D, Haessler J, van Rhee F et al..
Testing standard and genetic parameters in 220 patients with multiple myeloma with
complete data sets: superiority of molecular genetics.
Br J Haematol.
2007;
137
530-536
- 4
Tinguely M, Jenni B, Reineke T et al..
Chromosomal translocations t(4;14), t(11;14) and proliferation rate stratify patients
with mature plasma cell myelomas into groups with different survival probabilities:
a molecular epidemiologic study on tissue microarrays.
Am J Surg Pathol.
2007;
31
690-696
- 5
International Myeloma Working Group .
Criteria for the classification of monoclonal gammopathies, multiple myeloma and related
disorders.
Br J Haematol.
2003;
121
749-757
- 6
Greipp P R, San Miguel J, Durie B G et al..
International staging system for multiple myeloma.
J Clin Oncol.
2005;
23
3412-3420
- 7
Mulligan M E.
Imaging techniques used in the diagnosis, staging, and follow-up of patients with
myeloma.
Acta Radiol.
2005;
46
716-724
- 8
Durie B G, Salmon S E.
A clinical staging system for multiple myeloma.
Cancer.
1975;
36
842-854
- 9
Durie B G, Kyle R A, Belch A et al..
Myeloma management guidelines: a consensus report from the scientific advisors of
the international myeloma foundation.
Hematol J.
2003;
4
379-398
- 10
Moulopoulos L A, Maris T G, Papanikolaou N, Panagi G, Vlahos L, Dimopoulos M A.
Detection of malignant bone marrow involvement with dynamic contrast-enhanced magnetic
resonance imaging.
Ann Oncol.
2003;
14
152-158
- 11
Walker R, Barlogie B, Haessler J et al..
Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications.
J Clin Oncol.
2007;
25
1121-1128
- 12
Durie B G, Waxman A D, D'Agnolo A, Williams C M.
Whole-body 18F-FDG PET identifies high-risk myeloma.
J Nucl Med.
2002;
43
1457-1463
- 13
Gertz M A.
Relevant prognostic features of multiple myeloma and the new international staging
system.
Leuk Lymphoma.
2007;
48
458-468
- 14
Moulopoulos L A, Dimopoulos M A, Weber D, Fuller L, Libshitz H I, Alexanian R.
Magnetic resonance imaging in the staging of solitary plasmacytoma of bone.
J Clin Oncol.
1993;
11
1311-1315
- 15
Mulligan M E.
Myeloma and lymphoma.
Semin Musculoskelet Radiol.
2000;
4
127-135
- 16
Tsang R W, Gospodarowicz M K, Pintilie M et al..
Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome.
Int J Radiat Oncol Biol Phys.
2001;
50
113-120
- 17
Ooi G C, Chim J C, Au W Y, Khong P L.
Radiologic manifestations of primary solitary extramedullary and multiple solitary
plasmacytomas.
AJR Am J Roentgenol.
2006;
186
821-827
- 18
Weber D M, Dimopoulos M A, Moulopoulos L A, Delasalle K B, Smith T, Alexanian R.
Prognostic features of asymptomatic multiple myeloma.
Br J Haematol.
1997;
97
810-814
- 19
Blade J, Rosinol L.
Smoldering multiple myeloma and monoclonal gammopathy of undetermined significance.
Curr Treat Options Oncol.
2006;
7
237-245
- 20
Mulligan M E, Badros A Z.
PET/CT and MR imaging in myeloma.
Skeletal Radiol.
2007;
36
5-16
- 21
Dispenzieri A.
POEMS syndrome.
Hematol Am Soc Hematol Educ Program.
2005;
360-367
- 22
Horger M, Claussen C, Bross-Bach U et al..
Whole-body low-dose multidetector row-CT in the diagnosis of multiple myeloma: an
alternative to conventional radiography.
Eur J Radiol.
2005;
54
289-297
- 23
Mahnken A H, Wildberger J E, Gehbauer G et al..
Multidetector CT of the spine in multiple myeloma: comparison with MR imaging and
radiography.
AJR Am J Roentgenol.
2002;
178
1429-1436
- 24
Durie B G.
The role of anatomic and functional staging in myeloma: description of Durie/Salmon
PLUS staging system.
Eur J Cancer.
2006;
42
1539-1543
- 25
Hillengass J, Wasser K, Delorme S et al..
Lumbar bone marrow microcirculation measurements from dynamic contrast-enhanced magnetic
resonance imaging is a predictor of event-free survival in progressive multiple myeloma.
Clin Cancer Res.
2007;
13
475-481
- 26
Lecouvet F E, Dechambre S, Malghem J, Ferrant A, Vande Berg B C, Maldague B.
Bone marrow transplantation in patients with multiple myeloma: prognostic significance
of MR imaging.
AJR Am J Roentgenol.
2001;
176
91-96
- 27
Breyer R J, Mulligan M E, Smith S E, Line B R, Badros A Z.
Comparison of imaging with FDG PET/CT with other imaging modalities in myeloma.
Skeletal Radiol.
2006;
35
632-640
- 28
Bredella M A, Steinbach L, Caputo G, Segall G, Hawkins R.
Value of FDG PET in the assessment of patients with multiple myeloma.
AJR Am J Roentgenol.
2005;
184
1199-1204
- 29
Agool A, Schot B, Jager P, Vellenga E.
18F-FLT PET in hematologic disorders: a novel technique to analyze the bone marrow
compartment.
J Nucl Med.
2006;
47
1592-1598
- 30
Dankerl A, Liebisch P, Glatting G et al..
Multiple myeloma: molecular imaging with 11C-methionine PET/CT-initial experience.
Radiology.
2007;
242
498-508
- 31
Nanni C, Zamagni E, Cavo M et al..
11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple
myeloma.
World J Surg Oncol.
2007;
5
68-75
- 32
Mele A, Offidani M, Visani G et al..
Technetium-99m sestamibi scintigraphy is sensitive and specific for the staging and
the follow-up of patients with multiple myeloma: a multicentre study on 397 scans.
Br J Haematol.
2007;
136
729-735
- 33
Durie B G, Harousseau J L, Miguel J et al..
International uniform response criteria for multiple myeloma.
Leukemia.
2006;
20
1467-1473
- 34
Badros A, Weikel D, Salama A et al..
Osteonecrosis of the jaw in multiple myeloma patients: clinical features and risk
factors.
J Clin Oncol.
2006;
24
945-952
- 35
Lacy M Q, Dispenzieri A, Gertz M A et al..
Mayo Clinic consensus statement for the use of bisphosphonates in multiple myeloma.
Mayo Clin Proc.
2006;
81
1047-1053
Michael E MulliganM.D.
Department of Radiology, University of Maryland Medical Center
22 S. Greene St., Baltimore, MD 21201
eMail: mmulligan@umm.edu