Imaging of Multiple Myeloma: Present and Future.
Victor Rodriguez-LavalBlanca Lumbreras-FernándezBeatriz Aguado-BuenoNieves Gómez-LeónPublished in: Journal of clinical medicine (2024)
Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start treatment. Low-dose whole-body computed tomography (CT) is the modality of choice for the initial assessment, and dual-energy CT is a developing technique with the potential for detecting non-lytic marrow infiltration and evaluating the response to treatment. Magnetic resonance imaging (MRI) is more sensitive and specific than 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of small focal lesions and diffuse marrow infiltration. However, FDG-PET/CT is recommended as the modality of choice for follow-up. Recently, diffusion-weighted MRI has become a new technique for the quantitative assessment of disease burden and therapy response. Although not widespread, we address current proposals for structured reporting to promote standardization and diminish variations. This review provides an up-to-date overview of MM imaging, indications, advantages, limitations, and recommended reporting of each technique. We also cover the main differential diagnosis and pitfalls and discuss the ongoing controversies and future directions, such as PET-MRI and artificial intelligence.
Keyphrases
- computed tomography
- contrast enhanced
- positron emission tomography
- diffusion weighted
- dual energy
- magnetic resonance imaging
- artificial intelligence
- image quality
- multiple myeloma
- high resolution
- low dose
- bone marrow
- diffusion weighted imaging
- end stage renal disease
- pet imaging
- magnetic resonance
- ejection fraction
- big data
- chronic kidney disease
- randomized controlled trial
- real time pcr
- prognostic factors
- risk assessment
- bone mineral density
- adverse drug
- mass spectrometry
- newly diagnosed
- high dose
- decision making
- postmenopausal women
- label free
- high grade
- current status
- deep learning
- climate change