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浆细胞疾病的影像学——亚洲骨髓瘤网络骨成像工作组的共识建议

Imaging in plasma cell disorders-consensus recommendations of the Asian myeloma network bone imaging workgroup.

作者信息

Nagarajan Chandramouli, Anthony Natasha Fay, Hillengass Jens, Kim Seok Jin, Kunacheewa Chutima, Datukan Jay T, Gan Gin Gin, Binh Vo Thi Thanh, Chim James, Huang Jeffery S Y, Chen Wenming, Kim Kihyun, Rajkumar S Vincent, Durie Brian G M, Chng Wee Joo, Abe Masahiro

机构信息

Department of Haematology, Singapore General Hospital, Singapore.

Department of Haematology, National Cancer Centre, Singapore.

出版信息

Lancet Reg Health West Pac. 2025 Jun 7;59:101597. doi: 10.1016/j.lanwpc.2025.101597. eCollection 2025 Jun.

Abstract

The role of imaging in accurate classification and management of plasma cell disorders is substantial with the increasing evidence in the ability of cross-sectional imaging to identify disease related manifestations. International myeloma working group and nation-wide guidelines provide recommendations for guiding practice. However, there are remarkable variations in practice globally and in particular, adoption of incorrect imaging techniques due to lack of awareness/education, lack of equipment or personnel and resource constraints. These limitations are not specific to any particular geographic area. Hence in this complex and evolving imaging landscape, clinicians require practical guidance incorporating up-to-date and emerging evidence that is relevant to their healthcare system. In this manuscript we describe the two-pronged (minimum and enhanced) recommendations for imaging in different categories of plasma cell disorders from the Asian myeloma network bone imaging workgroup arrived through a questionnaire-based inquiry of prevailing imaging practices, discussion of those practices in the light of optimal evidence-based imaging recommendations, barriers in adoption of those recommendations and suggestions to overcome some of these barriers. There is an important role for these regionally relevant but globally applicable recommendations rooted in clinical practice which can serve as a medium for Physician/nursing, patient/carer education and to enable dialogue with healthcare technology appraisers/funders and secure interventions required to optimise practice in this field.

摘要

随着横断面成像识别疾病相关表现能力的证据不断增加,成像在浆细胞疾病的准确分类和管理中发挥着重要作用。国际骨髓瘤工作组和全国性指南为指导实践提供了建议。然而,全球范围内的实践存在显著差异,特别是由于缺乏认识/教育、缺乏设备或人员以及资源限制而采用不正确的成像技术。这些限制并非特定于任何特定地理区域。因此,在这个复杂且不断发展的成像领域,临床医生需要结合与其医疗系统相关的最新和新出现证据的实用指南。在本手稿中,我们描述了亚洲骨髓瘤网络骨成像工作组针对不同类别浆细胞疾病成像提出的双管齐下(最低限度和强化)建议,这些建议是通过对当前成像实践进行基于问卷的调查、根据最佳循证成像建议讨论这些实践、采用这些建议的障碍以及克服其中一些障碍的建议得出的。这些植根于临床实践、具有区域相关性但全球适用的建议具有重要作用,可作为医生/护士、患者/护理人员教育的媒介,并促进与医疗技术评估人员/资助者的对话,确保采取所需干预措施以优化该领域的实践。

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