title: Multiple myeloma: 18F-FDG-PET/CT and diagnostic imaging.
abstract: Multiple myeloma (MM) is a relatively rare hematologic disorder characterized by proliferation of plasma cells, primarily involving the bone marrow. Extramedullary involvement also occurs with poor prognosis. Asymptomatic plasma cell disorders, monoclonal gammopathy of uncertain significance, and smoldering MM, which do not require therapy, should be distinguished from symptomatic MM, which requires treatment. MM may present with CRAB, elevated Calcium levels, Renal insufficiency, Anemia, and Bone lesions (including lytic lesions and osteopenia), as well as elevated levels of serum M protein or urine M protein or both. Nonsecretory myeloma in which serum and urine M proteins are absent occurs rarely, accounting for 1%-5% of patients with myeloma, but low levels of abnormal immunoglobulins are often present. Staging of patients with MM is done according to the Durie and Salmon criteria based on laboratory testing (determination of hemoglobin, serum calcium, and serum and urine M proteins) and conventional radiography. A variety of diagnostic imaging procedures have been employed to assess the extent of disease in MM and to evaluate the response to treatment as well as provide surveillance for the detection of recurrent disease. These include whole-body x-ray, which despite its limitations is regularly used to detect lytic bone lesions; CT radiography; MRI; and a variety of radionuclide imaging procedures, with (18)F-FDG-PET/CT emerging as the radionuclide procedure of choice. Recently, the Durie-Salmon criteria have been upgrade to the Durie-Salmon PLUS system, which includes (18)F-FDG-PET/CT and MRI of the spine and pelvis.
authors.affiliation: Department of Nuclear Medicine, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia; Technical Faculty "Mihajlo Pupin" Zrenjanin, University of Novi Sad, Novi Sad, Serbia.
authors.forename: Jasna
authors.initials: J
authors.lastname: Mihailovic
authors.affiliation: Division of Nuclear Medicine & Molecular Imaging, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY; Department of Radiology, Weill Cornell Medical College, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY. Electronic address: sjg2002@med.cornell.edu.
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Goldsmith
mesh_terms: D019788:Fluorodeoxyglucose F18; D006801:Humans; D009101:Multiple Myeloma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18