Abstract
Multiple myeloma is a hematological malignancy of plasma cells usually detected due to various bone abnormalities on imaging and rare extraosseous abnormalities. The traditional approach for disease detection was based on plain radiographs, showing typical lytic lesions. Still, this technique has many limitations in terms of diagnosis and assessment of response to treatment. The new approach to assess osteolytic lesions in patients newly diagnosed with multiple myeloma is based on total-body low-dose CT. The purpose of this paper is to suggest a guide for radiologists in performing and evaluating a total-body low-dose CT in patients with multiple myeloma, both newly-diagnosed and in follow-up (pre and post treatment).
Highlights
Multiple myeloma (MM) is a clonal plasma cell proliferative disease characterized by primary bone marrow infiltration, which causes increased osteoclasts activity and decreased osteogenic activity, determining osteolytic lesions which eventually lead to hypercalcemia, renal failure, anemia, and/or osteolytic lesions; these manifestations are known as the acronym CRAB [4,5]
As multiple myeloma’s osteolytic lesions be small as mm to be considered for diagnosis, slice thickness when interpreting the as small as 5 mm to be considered for diagnosis, slice thickness when interpreting theaxial axial images images is is advisable advisable to to be be of of at at least least 33 mm, mm, ifif not not 1.25
magnetic resonance imaging (MRI) demonstrated demonstrated that that imaging imaging evaluation evaluation of of the thespine spinealone alone in patients can miss up to of myeloma lesions, a study must in MM patients can miss up to 50% of myeloma lesions, a WBLD-CT study must include include all all the the parts parts out out of of the the spine spine to to obtain obtain aacorrect correctstaging stagingand andrisk riskstratification stratificationof of MM patients [21]
Summary
Bone marrow is considered as a widespread organ (like bone, skin, and fat); it has a hematopoietic function and is composed of stem cells, red blood cells, myeloid cells, and megakaryocytes: these cells perform functions of great importance, as they take part in body oxygenation, immune control, and blood clotting. These cells are surrounded by a network of cancellous trabeculae (trabecular bone or spongy bone) and lined by fibrous connective tissue. In the late third decade, the bone marrow distribution becomes mature, with red marrow persisting in the axial skeleton (skull, spine, sternum, clavicles, scapulae, pelvis) and in the proximal metaphysis of the long bones [1,2,3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
