Raza Shahzad, Leng Siyang, Lentzsch Suzanne
Division of Hematology/Oncology, Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Ave, New York, NY, 10032, USA.
Curr Hematol Malig Rep. 2017 Jun;12(3):168-175. doi: 10.1007/s11899-017-0379-9.
Multiple myeloma (MM) is characterized by abnormal proliferation of plasma cells in the bone marrow leading to symptoms of anemia, renal failure, hypercalcemia, and bone lesions. Bone imaging is critical for the diagnosis, staging, assessment for the presence and extent of bone lesions, and initial treatment of MM. Skeletal survey is the preferred initial imaging modality due to its availability and low cost. However, it has poor sensitivity and patients with occult myeloma may escape detection, delaying their diagnosis and treatment. New cross-sectional imaging modalities such as low-dose whole body CT, MRI, and PET-CT have high sensitivity and specificity for detecting lytic lesions and extramedullary relapse in MM. The combined use of cross-sectional imaging may provide complimentary information for staging, prognosis, and disease monitoring. In this review, we will discuss commonly used imaging modalities and their advantages and disadvantages in the management of MM.
多发性骨髓瘤（MM）的特征是骨髓中浆细胞异常增殖，导致贫血、肾衰竭、高钙血症和骨病变等症状。骨成像对于MM的诊断、分期、评估骨病变的存在和范围以及初始治疗至关重要。骨骼X线检查因其可及性和低成本而成为首选的初始成像方式。然而，其敏感性较差，隐匿性骨髓瘤患者可能无法被检测到，从而延误诊断和治疗。新的断层成像方式，如低剂量全身CT、MRI和PET-CT，对检测MM中的溶骨性病变和髓外复发具有高敏感性和特异性。联合使用断层成像可为分期、预后和疾病监测提供补充信息。在本综述中，我们将讨论MM管理中常用的成像方式及其优缺点。
