title: Whole-body low-dose computed tomography and advanced imaging techniques for multiple myeloma bone disease.
abstract: Detection of lytic bone lesions is crucial in the workup for multiple myeloma and very often dictates the decision to start treatment. Conventional radiography, despite decades of use, is often insufficient for detection of bone disease in multiple myeloma. Modern imaging techniques such as MRI, PET, and CT offer superior detection of myeloma bone disease and extramedullary manifestations of plasma cell dyscrasias. Novel whole-body low-dose computed tomography (WBLDCT) protocols allow for collection of superior image detail of the skeleton at doses of radiation similar to those used for conventional planar radiography. Several studies have shown that WBLDCT has a superior detection rate for lytic bone lesions compared with whole-body X-ray (WBXR), potentially leading to restaging and changes in therapy. MRI and PET provide imaging data important for assessing disease activity and prognostication. Because of several advantages over WBXR, WBLDCT is already the standard imaging technique for use in patients with multiple myeloma in many European institutions. However, the radiographic skeletal survey or WBXR is still the initial study of choice used to screen for myeloma bone disease in many institutions. In this review, we aim to explore the changing landscape of imaging for myeloma bone disease through use of modern imaging techniques.
authors.affiliation: Department of Medicine, College of Physicians and Surgeons of Columbia University, New York-Presbyterian Hospital, New York, New York.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Pianko
authors.affiliation: Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra General Hospital, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Hematopoiesis, Hematological Malignancies and Immunology Research Program, Indiana University Simon Cancer Center, Bloomington, Indiana.
authors.forename: G David
authors.initials: GD
authors.lastname: Roodman
authors.affiliation: Department of Radiology, College of Physicians and Surgeons of Columbia University, New York, New York.
authors.forename: Chaitanya R
authors.initials: CR
authors.lastname: Divgi
authors.affiliation: Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Sonja
authors.initials: S
authors.lastname: Zweegman
authors.affiliation: Department of Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany. Department of Internal Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Hillengass
authors.affiliation: Department of Medicine, College of Physicians and Surgeons of Columbia University, New York-Presbyterian Hospital, New York, New York. Division of Hematology/Oncology, College of Physicians and Surgeons of Columbia University, New York, New York. sl3440@columbia.edu.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lentzsch
mesh_terms: D001847:Bone Diseases / Q000175:diagnosis* / Q000209:etiology*; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging