State of the art imaging of multiple myeloma: Comparative review of FDG PET/CT imaging in various clinical settings
Autor: | Lale Kostakoglu, Charles Mesguich, Reza Fardanesh, Lawrence Tanenbaum, Ajai Chari, Sundar Jagannath |
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Rok vydání: | 2014 |
Předmět: |
medicine.medical_specialty
Multimodal Imaging Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging Multiple myeloma Neoplasm Staging PET-CT medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Functional imaging medicine.anatomical_structure Positron emission tomography Positron-Emission Tomography Fdg pet ct Radiology Tomography Bone marrow Radiopharmaceuticals Multiple Myeloma Tomography X-Ray Computed Nuclear medicine business |
Zdroj: | European Journal of Radiology. 83:2203-2223 |
ISSN: | 0720-048X |
Popis: | 18-Flurodeoxyglucose Positron Emission Tomography with computed tomography (FDG PET/CT) and Magnetic Resonance Imaging (MRI) have higher sensitivity and specificity than whole-body X-ray (WBXR) survey in evaluating disease extent in patients with multiple myeloma (MM). Both modalities are now recommended by the Durie-Salmon Plus classification although the emphasis is more on MRI than PET/CT. The presence of extra-medullary disease (EMD) as evaluated by PET/CT imaging, initial SUVmax and number of focal lesions (FL) are deemed to be strong prognostic parameters at staging. MRI remains the most sensitive technique for the detection of diffuse bone marrow involvement in both the pre and post-therapy setting. Compression fractures are best characterized with MRI signal changes, for determining vertebroplasty candidates. While PET/CT allows for earlier and more specific evaluation of therapeutic efficacy compared to MRI, when signal abnormalities persist years after treatment. PET/CT interpretation, however, can be challenging in the vertebral column and pelvis as well as in cases with post-therapy changes. Hence, a reading approach combining the high sensitivity of MRI and superior specificity of FDG PET/CT would be preferred to increase the diagnostic accuracy. In summary, the established management methods in MM, mainly relying on biological tumor parameters should be complemented with functional imaging data, both at staging and restaging for optimal management of MM. |
Databáze: | OpenAIRE |
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