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J Clin Oncol. 2015 Feb 20;33(6):657-64. doi: 10.1200/JCO.2014.57.9961. Epub 2015 Jan 20.

Role of magnetic resonance imaging in the management of patients with multiple myeloma: a consensus statement.

Author information

1
Meletios A. Dimopoulos and Evangelos Terpos, National and Kapodistrian University of Athens School of Medicine, Athens, Greece; Jens Hillengass and Hartmut Goldschmidt, University Hospital Heidelberg, Heidelberg, Germany; Saad Usmani, Carolinas Healthcare System, Charlotte, NC; Elena Zamagni and Michele Cavo, Bologna University School of Medicine, Bologna; Antonio Palumbo, S. Giovanni Battista Hospital, University of Turin, Turin, Italy; Suzanne Lentzsch, Columbia University College of Physicians and Surgeons, New York, NY; Faith E. Davies, Institute of Cancer Research, Sutton, United Kingdom; Noopur Raje, Massachusetts General Hospital Cancer Center; Kenneth Anderson, Dana-Farber Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA; Orhan Sezer, Memorial Sisli Hospital, Istanbul, Turkey; Sonja Zweegman, VU University Medical Center, Amsterdam; Pieter Sonneveld, Erasmus University Medical Center, Rotterdam, the Netherlands; Jatin Shah, MD Anderson Cancer Center, Houston, TX; Ashraf Badros, University of Maryland Medical Center, Baltimore, MD; Kazuyuki Shimizu, Tokai Central Hospital, Kakamigahara, Japan; Philippe Moreau, University Hospital Hôtel-Dieu, Nantes, France; Chor-Sang Chim, Queen Mary Hospital, University of Hong Kong, Hong Kong, Special Administrative Region; Jian Hou, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China; Juan José Lahuerta, Hospital Universitario 12 de Octubre, Madrid, Spain; Artur Jurczyszyn, University Hospital, Krakow, Poland; Heinz Ludwig, Wilhelminenspital, Vienna, Austria; Bart Barlogie, University of Arkansas for Medical Sciences, Little Rock, AR; G. David Roodman, Indiana University School of Medicine, Indianapolis, IN; S. Vincent Rajkumar, Mayo Clinic, Rochester, MN; and Brian G.M. Durie, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA. mdimop@med.uoa.gr.
2
Meletios A. Dimopoulos and Evangelos Terpos, National and Kapodistrian University of Athens School of Medicine, Athens, Greece; Jens Hillengass and Hartmut Goldschmidt, University Hospital Heidelberg, Heidelberg, Germany; Saad Usmani, Carolinas Healthcare System, Charlotte, NC; Elena Zamagni and Michele Cavo, Bologna University School of Medicine, Bologna; Antonio Palumbo, S. Giovanni Battista Hospital, University of Turin, Turin, Italy; Suzanne Lentzsch, Columbia University College of Physicians and Surgeons, New York, NY; Faith E. Davies, Institute of Cancer Research, Sutton, United Kingdom; Noopur Raje, Massachusetts General Hospital Cancer Center; Kenneth Anderson, Dana-Farber Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA; Orhan Sezer, Memorial Sisli Hospital, Istanbul, Turkey; Sonja Zweegman, VU University Medical Center, Amsterdam; Pieter Sonneveld, Erasmus University Medical Center, Rotterdam, the Netherlands; Jatin Shah, MD Anderson Cancer Center, Houston, TX; Ashraf Badros, University of Maryland Medical Center, Baltimore, MD; Kazuyuki Shimizu, Tokai Central Hospital, Kakamigahara, Japan; Philippe Moreau, University Hospital Hôtel-Dieu, Nantes, France; Chor-Sang Chim, Queen Mary Hospital, University of Hong Kong, Hong Kong, Special Administrative Region; Jian Hou, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China; Juan José Lahuerta, Hospital Universitario 12 de Octubre, Madrid, Spain; Artur Jurczyszyn, University Hospital, Krakow, Poland; Heinz Ludwig, Wilhelminenspital, Vienna, Austria; Bart Barlogie, University of Arkansas for Medical Sciences, Little Rock, AR; G. David Roodman, Indiana University School of Medicine, Indianapolis, IN; S. Vincent Rajkumar, Mayo Clinic, Rochester, MN; and Brian G.M. Durie, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA.

Abstract

PURPOSE:

The aim of International Myeloma Working Group was to develop practical recommendations for the use of magnetic resonance imaging (MRI) in multiple myeloma (MM).

METHODS:

An interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations for the value of MRI based on data published through March 2014.

RECOMMENDATIONS:

MRI has high sensitivity for the early detection of marrow infiltration by myeloma cells compared with other radiographic methods. Thus, MRI detects bone involvement in patients with myeloma much earlier than the myeloma-related bone destruction, with no radiation exposure. It is the gold standard for the imaging of axial skeleton, for the evaluation of painful lesions, and for distinguishing benign versus malignant osteoporotic vertebral fractures. MRI has the ability to detect spinal cord or nerve compression and presence of soft tissue masses, and it is recommended for the workup of solitary bone plasmacytoma. Regarding smoldering or asymptomatic myeloma, all patients should undergo whole-body MRI (WB-MRI; or spine and pelvic MRI if WB-MRI is not available), and if they have > one focal lesion of a diameter > 5 mm, they should be considered to have symptomatic disease that requires therapy. In cases of equivocal small lesions, a second MRI should be performed after 3 to 6 months, and if there is progression on MRI, the patient should be treated as having symptomatic myeloma. MRI at diagnosis of symptomatic patients and after treatment (mainly after autologous stem-cell transplantation) provides prognostic information; however, to date, this does not change treatment selection.

PMID:
25605835
DOI:
10.1200/JCO.2014.57.9961
[Indexed for MEDLINE]

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