Abstract
Multiple myeloma (MM) is a hematological neoplasm characterized by the clonal proliferation of malignant plasma cells in the bone marrow. MM results in diffuse or focal bone infiltration and extramedullary lesions. Over the past two decades, advances have been made with regard to the diagnosis, staging, treatment, and imaging of MM. Computed tomography (CT) and magnetic resonance imaging (MRI) are currently recommended as the most effective imaging modalities at diagnostic. Yet, recent data from the literature suggest that positron emission tomography combined with computed tomography (PET/CT) using 18F-deoxyglucose (FDG) is a promising technique for initial staging and therapeutic monitoring in this pathology. This paper reviews the recent advances as well as the potential place of a more specific radiopharmaceutical in MM.
Highlights
Multiple myeloma (MM) is a malignancy characterized by the clonal proliferation of plasma cells
magnetic resonance imaging (MRI) is recommended in Smoldering multiple myeloma (SMM) patients: patients presenting more than 1 non-equivocal focal bone lesion (FL) must be considered as suffering from symptomatic MM and requiring treatment [2,3]
In a series of 122 patients with SMM, Siontis et al [10] demonstrated that the probability of progression within two years of patients with positive FDG-Positron emission tomography (PET) was 75% vs. 30% in patients with negative FDG-PET, without therapy
Summary
Multiple myeloma (MM) is a malignancy characterized by the clonal proliferation of plasma cells. The definition of symptomatic MM, a clinical staging requiring treatment, was traditionally based on the presence of organ damage related to plasma cell growth as defined by CRAB criteria (hypercalcemia, renal insufficiency, anemia and the presence of bone lesions). This definition was revised in 2014 by the International Myeloma Working Group (IMWG), integrating new prognostic biomarkers, with the aim of not delaying the initiation of treatment of high-risk SMM-classified patients and to avoid the establishment of harmful bone lesions or renal impairment [2]. Other radiopharmaceuticals targeting alternative MM biomarkers have shown promising results, such as radio-labeled choline, 68Ga-Pentixafor targeting C–X–C chemokine receptor type 4 (CXCR4), and immuno-PET using radiolabeled monoclonal antibodies (mAbs) as a companion of antibody-based therapies [12,13,14,15,16]
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