title: MR imaging and PET/CT in diagnosis and management of multiple myeloma.
abstract: Multiple myeloma is a common hematologic malignancy among the elderly population. Although there have been many advances in treatment over the past few decades, the overall prognosis for the disease remains poor. Conventional radiography has long been the standard of reference for the imaging of multiple myeloma. However, 10%-20% of patients with multiple myeloma do not have evidence of disease at conventional radiography. There is a growing body of evidence supporting use of magnetic resonance (MR) imaging and 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in diagnosis and management of multiple myeloma. MR imaging is useful in detection of bone marrow infiltration, a finding often missed at conventional radiography. FDG PET/CT is especially sensitive for the detection of extramedullary disease and can help detect the metabolically active lesions that often precede evidence of osseous destruction at conventional radiography. MR imaging and FDG PET/CT are useful tools that can provide essential information for diagnosis and management of patients with multiple myeloma. Both modalities allow accurate localization of disease after chemotherapy or autologous stem cell transplantation and can provide important prognostic information that can influence further clinical decision making regarding therapy, particularly when tumor serum markers may be a less reliable indicator of disease burden after repeated treatments.
authors.affiliation: From the Department of Radiology, Boston University School of Medicine, Boston, Mass (R.F., A.A.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.L.M.M., P.J.P.); Russell H. Morgan Department of Radiology and Radiological Sciences, Department of Oncology, and Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins School of Medicine, 601 N Caroline St, JHOC 3235, Baltimore, MD 21287 (R.M.S.); and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md (R.M.S.).
authors.forename: Regan
authors.initials: R
authors.lastname: Ferraro
authors.forename: Ankit
authors.initials: A
authors.lastname: Agarwal
authors.forename: Erica L
authors.initials: EL
authors.lastname: Martin-Macintosh
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Peller
authors.forename: Rathan M
authors.initials: RM
authors.lastname: Subramaniam
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000235:genetics; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed