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Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):15-29

DOI: 10.23736/S2283-8376.17.00004-3


language: Italian

Comparison between whole-body MRI and 18F-FDG PET/CT in multiple myeloma staging

Francesco SANI 1 , Manuela VERRUSIO 1, Renata TODARO 2, Virginia D'ANDREA 1, Valentina MORINI 1, Giovanna LEONARDI 3, Alessandra CASOLO 4, Roberto MARASCA 3, Pietro TORRICELLI 1

1 Dipartimento di Radiologia, Università di Modena e Reggio Emilia, Modena, Italia; 2 Unità Operativa Complessa di Radiodiagnostica e Radioterapia, Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate G. Ingrassia, Università degli Studi di Catania, Catania, Italia; 3 Divisione di Ematologia, Dipartimento di Scienze Mediche e Chirurgiche, Università di Modena e Reggio Emilia, Modena, Italia; 4 Dipartimento di Medicina Nucleare, Università di Modena e Reggio Emilia, Modena, Italia


BACKGROUND: The aim of this study was to evaluate the role of whole-body MRI (WB-MRI) and 18F-fluorodeoxyglucose positron-emission tomography computed tomography (FDG-PET/CT) in the detection of bone lesions in patients with new diagnosis of multiple myeloma (MM) and in the staging. CT images for attenuation correction in PET were reassessed, comparing them with the corresponding MRI, in order to evaluate a correspondence between bone marrow lesions detected on MRI and lithic lesions on CT images for attenuation correction.
METHODS: A retrospective evaluation was performed on a total of 14 patients with newly diagnosed MM, confirmed by bone marrow biopsy, all subjected to WB-MRI and FDG-PET/CT before starting the therapeutic treatments. In both methods, only bone focal lesions with a minimum diameter of 1 cm were taken into account.
RESULTS: In our study we found a significant difference between the total number of focal lesions detected with the two methods: in 8 of 14 patients, PET/CT did not identify a total of 56 focal lesions and a diffuse marrow infiltration in the whole spine. At the re-evaluation of CT images for attenuation correction, it was found that all focal lesions greater than 1 cm identified on MRI and included in CT scanning volume, are identifiable as areas of focal osteolysis on CT images.
CONCLUSIONS: WB-MRI shows greater accuracy than PET/CT in the detection of MM bone marrow lesions, for the characterization of both focal bone lesions and widespread bone marrow infiltration; if available could be the first-choice imaging method for the classification and staging of patients with new MM diagnosis.

KEY WORDS: Multiple myeloma - Magnetic resonance imaging - Positron-emission tomography/computed tomography

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