title: Computed tomography assessment of bone lesions in patients with POEMS syndrome.
abstract: OBJECTIVE
  To describe the imaging findings on computed tomography (CT) and skeletal survey (SS) in patients with POEMS syndrome.
  
  
  METHODS
  We retrospectively reviewed, with institutional review board approval, the dysproteinemia database at our institution for patients with new diagnosis of POEMS syndrome between January 1998 and December 2008. Twenty-four patients were identified with PET/CT or CT and had skeletal survey (SS) available for review.
  
  
  RESULTS
  Twenty-four patients were included in the study group with median age of 47 years. All CTs demonstrated at least one sclerotic lesion. The most common pattern was multiple small lesions, with 18 patients (75%) having at least 5 lesions less than 1 cm. The larger lesions had a central lytic component and were FDG avid. SS had a false negative rate of 36% (8 patients). Serial CT after treatment showed a decrease in size and number of sclerotic lesions in 53% of cases (13 patients), the majority showing increased sclerosis. Two patients had complete resolution of sclerotic lesions.
  
  
  CONCLUSIONS
  CT identified sclerotic lesions in all study patients with POEMS syndrome, the majority being less than 1 cm in size, which were not identified radiographically. CT may demonstrate increased sclerosis or even resolution of sclerotic lesions corresponding to treatment response.
  
  
  CONCLUSIONS
  • CT has high sensitivity in identifying sclerotic lesions in POEMS syndrome • Most common CT patterns are multiple, less than 1 cm, sclerotic lesions • Larger lesions have lytic centres and sclerotic margins • Skeletal surveys may have a false negative rate of 36% • Treatment response includes increased sclerosis, decrease in size or resolution of lesions.
authors.affiliation: Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA, Glazebrook.katrina@mayo.edu.
authors.forename: K
authors.initials: K
authors.lastname: Glazebrook
authors.forename: Francis L
authors.initials: FL
authors.lastname: Guerra Bonilla
authors.forename: Adam
authors.initials: A
authors.lastname: Johnson
authors.forename: S
authors.initials: S
authors.lastname: Leng
authors.forename: A
authors.initials: A
authors.lastname: Dispenzieri
mesh_terms: D000328:Adult; D000368:Aged; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*