Whole-Body 64-Slice Multidetector Computed Tomography (MDCT) Identifies High-Risk Myeloma

Giuseppe Mele, Grazia D’Agostino, Giacomo Loseto, Maria Rosaria Coppi, Angela Melpignano, Grazia Angone, Giovanni Quarta

Haematology Division and BMT Unit, Antonio Perrino Hospital Hospital, Brindisi, Italy.
Radiology Division Antonio Perrino Hospital Hospital, Brindisi, Italy.

DOI: 10.4236/ijcm.2012.37115                

Abstract

Background: In Multiple Myeloma (MM) the individuation of bone lesions at baseline is mandatory because the detection of cortical damage reflects prognostic implications. Conventional Radiography (CR) shows osteolytic bone lesions only when the cortical bone damage is more than 30%. Whole-body 64-slice multidetector computed tomography (MDCT) has recently been employed for detecting early osteolytic disease. Patients and Methods: Twenty-height patients with Asymptomatic MM according to IMWG criteria underwent a 64 MDCT. Results: In our experience MDCT revealed osteolysis in 14/28 patients with normal skeletal survey and in 6 patients with normal Magnetic Resonance Imaging (MRI). Patients with radiological evidence of bone disease on MDCT were at high risk of progression with a median time to progression of 5 months (range 1 - 26 months) in comparison with patients without radiological evidence of bone disease who, conversely, showed a median time to progression of 20 months (range 8 - 40 months) (P = 0.0001). Conclusions: MDCT is able to identify MM patients with a high risk of progression, who might benefit from early therapy.

Keywords

Asymptomatic Myeloma; MDCT; MRI; Conventional Radiography

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	M. Dimopoulos, E. Terpos, R. L. Comenzo, et al., “International Myeloma Working Group Consensus Statement and Guidelines Regarding the Current Role of Imaging Techniques in the Diagnosis and Monitoring of Multiple Myeloma,” Leukemia, Vol. 23, 2009, pp. 1545-1556. doi:10.1038/leu.2009.89
[2]	B. G. Durie, R. A. Kyle, A. Belch, et al., “Myeloma Man- agement Guidelines: A Consensus Report from the Scientific Advisors of the International Myeloma Foundation,” Hematology Journal, Vol. 4, 2003, pp. 379-398. doi:10.1038/sj.thj.6200312
[3]	D. M. Weber, M. Dimopoulos, L. A. Moulopoulos, et al., “Prognostic Features of Asymptomatic Multiple Myeloma,” British Journal of Hematology, Vol. 97, No. 4, 1996, pp. 810-814. doi:10.1046/j.1365-2141.1997.1122939.x
[4]	F. E. Lecouvet, B. C. Vande Berg, J. Malghem & B. E. Maldague, “Magnetic Resonance and Computed Tomo- graphy Imaging in Multiple Myeloma,” Seminars in Musculoskeletal Radiology, Vol. 5, No. 1, 2001, pp. 43- 55. doi:10.1055/s-2001-12920
[5]	A. Baur-Melnyk, S. Buhmann, C. Becker, et al., “Whole-Body MRI versus Whole-Body MDCT for Staging of Multiple Myeloma,” American Journal of Roentgenology, Vol. 190, No. 4, 2008, pp. 1097-1104. doi:10.2214/AJR.07.2635
[6]	M. Horger, L. Kanz, B. Denecke, et al., “The Benefit of Using Whole-Body, Low-Dose, Nonenhanced, Multidetector Computed Tomography for Follow-Up and Therapy Response Monitoring in Patients Whit Multiple Myeloma,”, Cancer, Vol. 109, No. 8, 2007, pp. 1617-1626. doi:10.1002/cncr.22572
[7]	F. Wisloff, P. Andersen, T. R. Andersson, et al., “Incidence and Follow-Up of Asymptomatic Multiple Myeloma. The Myeloma Project of Health Region I in Norway,” European Journal of Haematology, Vol. 47, No. 5, 1991, pp. 338-341. doi:10.1111/j.1600-0609.1991.tb01857.x
[8]	A. Baur-Melnyk and M. Reiser, “Staging of Multiple Myeloma with MRI: Comparison to MSCT and Conventional Radiography,” Radiologe, Vol. 44, No. 9, 2004, pp. 874-881.
[9]	M. Dimopoulos, P. G. Richardson, N. Brandenburg, et al., “A Review of Second Primary Malignancy in Patients with Relapsed or Refractory Multiple Myeloma Treated with Lenalidomide,” Blood, Vol. 119, No. 12, 2012, pp. 2764-2767. doi:10.1182/blood-2011-08-373514