Mesguich Charles, Hulin Cyrille, Latrabe Valérie, Lascaux Axelle, Bordenave Laurence, Hindié Elif
Department of Nuclear Medicine, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
University of Bordeaux, IMB, UMR CNRS 5251, INRIA Project Team Monc, Talence, France.
Front Nucl Med. 2022 Feb 22;1:808627. doi: 10.3389/fnume.2021.808627. eCollection 2021.
During the last two decades, the imaging landscape of multiple myeloma (MM) has evolved with whole-body imaging techniques such as fluorodeoxyglucose positron emission tomography-computed tomography (F-FDG PET/CT) and MRI replacing X-ray skeletal survey. Both imaging modalities have high diagnostic performance at the initial diagnosis of MM and are key players in the identification of patients needing treatment. Diffusion-weighted MRI has a high sensitivity for bone involvement, while F-FDG PET/CT baseline parameters carry a strong prognostic value. The advent of more efficient therapeutics, such as immunomodulatory drugs and proteasome inhibitors, has called for the use of sensitive imaging techniques for monitoring response to treatment. Diffusion-weighted MRI could improve the specificity of MRI for tumor response evaluation, but questions remain regarding its role as a prognostic factor. Performed at key time points of treatment in newly diagnosed MM patients, F-FDG PET/CT showed a strong association with relapse risk and survival. The deployment of minimal residual disease detection at the cellular or the molecular level may raise questions on the role of these imaging techniques, which will be addressed. This review summarizes and outlines the specificities and respective roles of MRI and F-FDG PET/CT in the management of MM.
在过去二十年中,多发性骨髓瘤(MM)的成像格局随着全身成像技术的发展而演变,诸如氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(F-FDG PET/CT)和MRI取代了X线骨骼检查。这两种成像方式在MM的初始诊断中都具有很高的诊断性能,并且是识别需要治疗的患者的关键手段。扩散加权MRI对骨受累具有高敏感性,而F-FDG PET/CT基线参数具有很强的预后价值。免疫调节药物和蛋白酶体抑制剂等更有效治疗方法的出现,要求使用敏感的成像技术来监测治疗反应。扩散加权MRI可以提高MRI评估肿瘤反应的特异性,但其作为预后因素的作用仍存在疑问。在新诊断的MM患者治疗的关键时间点进行的F-FDG PET/CT显示与复发风险和生存率密切相关。在细胞或分子水平上进行微小残留病检测可能会引发关于这些成像技术作用的问题,本文将对此进行探讨。本综述总结并概述了MRI和F-FDG PET/CT在MM管理中的特异性和各自作用。