Abstract
Aim of the study is to compare the agreement between whole-body low-dose computed tomography (WBLDCT) and magnetic resonance imaging (WBMRI) in the evaluation of bone marrow involvement in patients with multiple myeloma (MM). Patients with biopsy-proven MM, who underwent both WBLDCT and WBMRI were retrospectively enrolled. After identifying the presence of focal bone involvement (focal infiltration pattern), the whole skeleton was divided into five anatomic districts (skull, spine, sternum and ribs, pelvis, and limbs). Patients were grouped according to the number and location of the lytic lesions (<5, 5–20, and >20) and Durie and Salmon staging system. The agreement between CT and MRI regarding focal pattern, staging, lesion number, and distribution was assessed using the Cohen Kappa statistics. The majority of patients showed focal involvement. According to the distribution of the focal lesions and Durie Salmon staging, the agreement between CT and MRI was substantial or almost perfect (all κ > 0.60). The agreement increased proportionally with the number of lesions in the pelvis and spine (κ = 0.373 to κ = 0.564, and κ = 0.469–0.624), while for the skull the agreement proportionally decreased without reaching a statistically significant difference (p > 0.05). In conclusion, WBLDCT showed an almost perfect agreement in the evaluation of focal involvement, staging, lesion number, and distribution of bone involvement in comparison with WBMRI.
Highlights
The diagnosis of MM mainly relies on the demonstration of bone marrow plasmacytosis and/or presence of monoclonal proteins (M-proteins) in the serum or urine, and/or detection of end-organ damage (CRAB—hypercalcemia, renal failure, anemia, and bone disease), especially lytic bone lesions, based on the International Myeloma Working Group (IMWG) diagnostic criteria published in 2014 [1,4,5,6]
This study aims to compare the agreement between whole-body low-dose computed tomography (WBLDCT) and Whole-body MRI (WBMRI) in the evaluation of bone marrow involvement in patients with MM in different stages of the disease
Inclusion criteria were: (1) age > 18 years, (2) diagnosis of MM according to the International Myeloma Working Group, (3) having undergone at least a WBMRI and a WBLDCT examination for staging purposes or during the follow-up of disease, and (4) a maximum 6 months interval between the two diagnostic exams
Summary
Introduction published maps and institutional affilMultiple myeloma (MM) is a monoclonal plasma cell proliferative disorder characterized by primary bone marrow infiltration and excessive production of abnormal monoclonal immunoglobulin [1].Up to 90% of patients with MM develop bone lesions during illness course, underlining the importance of imaging examinations at the time of diagnosis and during follow-up, especially considering that number and size of focal bone lesions have been shown to predict outcome [2,3].The diagnosis of MM mainly relies on the demonstration of bone marrow plasmacytosis and/or presence of monoclonal proteins (M-proteins) in the serum or urine, and/or detection of end-organ damage (CRAB—hypercalcemia, renal failure, anemia, and bone disease), especially lytic bone lesions, based on the International Myeloma Working Group (IMWG) diagnostic criteria published in 2014 [1,4,5,6]. Multiple myeloma (MM) is a monoclonal plasma cell proliferative disorder characterized by primary bone marrow infiltration and excessive production of abnormal monoclonal immunoglobulin [1]. Up to 90% of patients with MM develop bone lesions during illness course, underlining the importance of imaging examinations at the time of diagnosis and during follow-up, especially considering that number and size of focal bone lesions have been shown to predict outcome [2,3]. The diagnosis of MM mainly relies on the demonstration of bone marrow plasmacytosis and/or presence of monoclonal proteins (M-proteins) in the serum or urine, and/or detection of end-organ damage (CRAB—hypercalcemia, renal failure, anemia, and bone disease), especially lytic bone lesions, based on the International Myeloma Working Group (IMWG) diagnostic criteria published in 2014 [1,4,5,6].
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