A recent study published in the American Journal of Roentgenology compared the detection rate of bone lesions and assessed accuracy of staging in whole-body MRI and whole-body multidetector CT, and found that whole-body MRI leads to a significantly higher detection rate and stagings in patients with multiple myeloma.
About 10% percent of all hematologic malignancies are secondary to multiple myeloma, and detection of skeletal involvement is critical for staging, treatment planning and prognosis for patients with multiple myeloma.
Myeloma can present with multiple punched-out lesions, but can also be diffusely infiltrating, mimicking osteoporosis. Prior studies demonstrated radiographs to be false negative in 30–70% of the cases.
The prospective study enrolled 41 newly diagnosed patients. All had whole-body multidetector CT, whole-body MRI, and iliac crest biopsies. Both CT and MRI were performed from the skull to the knees.
MRI Results
CT Results
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Whole-body cross-sectional imaging showed replaced radiographs to be ideal with MRI, but if that is not feasible, multidetector CT should be performed.
The radiation dose for a low-dose CT is only slightly more than for a skeletal survey. This is not significant in a tumor patient with limited survival.
The study concludes that whole-body MRI leads to a significantly higher detection rate and stagings than whole-body multidetector CT in patients with multiple myeloma.
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Reference: Baur-Melnyk A, Buhmann S, et al. Whole-Body MRI Versus Whole-Body MDCT for Staging of Multiple Myeloma. AJR Am J Roentgenol 2008; 190 (April): 1097–1104.
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Tags: ALL, AVA, bone lesions, CSF, CT, ct and mri, CT scan, detection of multiple myeloma, diagnosis and staging of multiple myeloma, diagnostic, Diagnostic Imaging, EFE, iliac crest biopsies, iliac crest biopsy, imaging, MDCT, MI, MR, mri, multidetector CT, multiple myeloma, PE, rad, radiation, radiograph, radiographs, radiologist, radiology, scanning, SPECT, TEE, whole-body MRI, whole-body multidetector CT scan
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