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Real Life Use of Imaging in the Management of Newly Diagnosed Patients with Myeloma- Practical Perspectives from a UK Hospital

Background: The role of imaging in myeloma has gained increasing importance over the past few years. Cross‐sectional imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and 18fluoro‐deoxyglucose (18F‐FDG) positron emission tomography (PET/CT) have increased sensitiv...

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Bibliographic Details
Published in:Blood 2019-11, Vol.134 (Supplement_1), p.5513-5513
Main Authors: Xu, Ke, Fowkes, Lucy, Willis, Fenella, Reyal, Yasmin
Format: Article
Language:English
Online Access:Get full text
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Summary:Background: The role of imaging in myeloma has gained increasing importance over the past few years. Cross‐sectional imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and 18fluoro‐deoxyglucose (18F‐FDG) positron emission tomography (PET/CT) have increased sensitivity of detection of myeloma bone lesions compared to skeletal plain radiographs. However, there is huge variation in practice both within the United Kingdom and internationally, as to the choice of modality due to differences in access to the techniques and the subtleties of the information gained from each type of imaging. At present whole body (WB) diffusion weighted (DW) MRI is not yet available in our hospital. Aim: To review compliance of our current practice with the 2017 British Society for Haematology (BSH) guideline “Use of imaging in the management of patients with myeloma”. To review the number of imaging modalities performed in newly diagnosed myeloma patients. Audit Standard Criteria range: 100%, or if not achieved, there is documentation in the case notes that explains the variance. • Patient with suspected myeloma underwent whole body MRI (WB-MRI) or CT (unless excluded due to unsuitability of procedure for the patient). • Patient without established myeloma defining event (MDE) but with bone marrow plasma cells 10-60% and/or M-protein >30g/l underwent WB-MRI, WB-CT or PET/CT. • WB/DW-MRI or PET/CT performed in the assessment of oligosecretory myeloma. • Whole spine MRI performed and reported within 24 hours of suspected cord compression in myeloma. • PET/CT or WB/DW-MRI performed in the diagnostic assessment of possible solitary plasmacytoma. Method: Data collection period was between 1st July 2017 to 30th June 2018. We included all adult patients (age at least18 years) who were newly diagnosed with myeloma or plasmacytoma in our Trust during the data collection period, and had their diagnostic imaging in our Trust.Data were retrospectively collected from multidisciplinary meeting lists, chemotherapy list, radiology department data and electronic patient record (EPR). Results: Forty patients were included in the audit, which included 31 myeloma patients, 8 smouldering myeloma patients, one plasmacytoma patient. There were no non-secretory or oligosecretory myeloma cases and there were no newly diagnosed myeloma patients presenting with suspected cord compression in our Trust during the data collection period. All patients (100%) with suspected my
ISSN:0006-4971
1528-0020
DOI:10.1182/blood-2019-121504