title: Bone marrow abnormalities and early bone lesions in multiple myeloma and its precursor disease: a prospective study using functional and morphologic imaging.
abstract: The incidence and importance of bone marrow involvement and/or early bone lesions in multiple myeloma (MM) precursor diseases is largely unknown. This study prospectively compared the sensitivity of several imaging modalities in monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM) and MM. Thirty patients (10 each with MGUS, SMM and MM) were evaluated with skeletal survey, [18F]FDG-PET/CT, [18F]NaF-PET/CT and morphologic dynamic contrast enhanced (DCE)-MRI. An additional 16 SMM patients had skeletal surveys and FDG-PET/CT. Among MGUS patients, DCE-MRI found only one focal marrow abnormality; other evaluations were negative. Among 26 SMM patients, five (19%) were re-classified as MM based on lytic bone lesions on CT and six had unifocal or diffuse marrow abnormality. Among MM, marrow abnormalities were observed on FDG-PET/CT in 8/10 patients and on DCE-MRI in nine evaluable patients. Abnormal NaF uptake was observed only in MM patients with lytic lesions on CT, providing no additional clinical information.
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;|b Levine Cancer Institute , Carolinas HealthCare System , Charlotte , NC , USA ;
authors.forename: Manisha
authors.initials: M
authors.lastname: Bhutani
authors.affiliation: c Molecular Imaging Program , CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Esther
authors.initials: E
authors.lastname: Tan
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;|d Memorial Sloan-Kettering Cancer Center , New York , NY , USA ;
authors.forename: Neha
authors.initials: N
authors.lastname: Korde
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Mary
authors.initials: M
authors.lastname: Kwok
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;|e The University of Texas MD Anderson Cancer Center , Houston , TX , USA ;
authors.forename: Elisabet E
authors.initials: EE
authors.lastname: Manasanch
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Nishant
authors.initials: N
authors.lastname: Tageja
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Sham
authors.initials: S
authors.lastname: Mailankody
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Mark
authors.initials: M
authors.lastname: Roschewski
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Marcia
authors.initials: M
authors.lastname: Mulquin
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Ashley
authors.initials: A
authors.lastname: Carpenter
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lamping
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Alex R
authors.initials: AR
authors.lastname: Minter
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;|f Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA ;
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Weiss
authors.affiliation: c Molecular Imaging Program , CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Esther
authors.initials: E
authors.lastname: Mena
authors.affiliation: c Molecular Imaging Program , CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Liza
authors.initials: L
authors.lastname: Lindenberg
authors.affiliation: g Hematology Section , DLM, CC, NIH , Bethesda , MD , USA.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Calvo
authors.affiliation: g Hematology Section , DLM, CC, NIH , Bethesda , MD , USA.
authors.forename: Irina
authors.initials: I
authors.lastname: Maric
authors.affiliation: b Levine Cancer Institute , Carolinas HealthCare System , Charlotte , NC , USA ;
authors.forename: Saad Z
authors.initials: SZ
authors.lastname: Usmani
authors.affiliation: c Molecular Imaging Program , CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.affiliation: c Molecular Imaging Program , CCR, NCI, NIH , Bethesda , MD , USA ;
authors.forename: Karen
authors.initials: K
authors.lastname: Kurdziel
authors.affiliation: a Multiple Myeloma Section , Lymphoid Malignancies Branch, CCR, NCI, NIH , Bethesda , MD , USA ;|d Memorial Sloan-Kettering Cancer Center , New York , NY , USA ;
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001853:Bone Marrow / Q000473:pathology*; D001842:Bone and Bones / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000000981:diagnostic imaging; D009101:Multiple Myeloma / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D011230:Precancerous Conditions
chemical_list: D015415:Biomarkers; D019788:Fluorodeoxyglucose F18
keywords: DCE-MRI; FDG; MGUS; NaF; PET/CT; functional imaging; multiple myeloma; smoldering myeloma