Bhutani Manisha, Turkbey Baris, Tan Esther, Korde Neha, Kwok Mary, Manasanch Elisabet E, Tageja Nishant, Mailankody Sham, Roschewski Mark, Mulquin Marcia, Carpenter Ashley, Lamping Elizabeth, Minter Alex R, Weiss Brendan M, Mena Esther, Lindenberg Liza, Calvo Katherine R, Maric Irina, Usmani Saad Z, Choyke Peter L, Kurdziel Karen, Landgren Ola
a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
b Levine Cancer Institute , Carolinas HealthCare System , Charlotte , NC , USA ;
Leuk Lymphoma. 2016 May;57(5):1114-21. doi: 10.3109/10428194.2015.1090572. Epub 2016 Apr 7.
The incidence and importance of bone marrow involvement and/or early bone lesions in multiple myeloma (MM) precursor diseases is largely unknown. This study prospectively compared the sensitivity of several imaging modalities in monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM) and MM. Thirty patients (10 each with MGUS, SMM and MM) were evaluated with skeletal survey, [18F]FDG-PET/CT, [18F]NaF-PET/CT and morphologic dynamic contrast enhanced (DCE)-MRI. An additional 16 SMM patients had skeletal surveys and FDG-PET/CT. Among MGUS patients, DCE-MRI found only one focal marrow abnormality; other evaluations were negative. Among 26 SMM patients, five (19%) were re-classified as MM based on lytic bone lesions on CT and six had unifocal or diffuse marrow abnormality. Among MM, marrow abnormalities were observed on FDG-PET/CT in 8/10 patients and on DCE-MRI in nine evaluable patients. Abnormal NaF uptake was observed only in MM patients with lytic lesions on CT, providing no additional clinical information.
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