Imaging of Multiple Myeloma: Present and Future

Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-01, Vol.13 (1), p.264
Main Authors: Rodríguez-Laval, Víctor, Lumbreras-Fernández, Blanca, Aguado-Bueno, Beatriz, Gómez-León, Nieves
Format: Article
Language:English
Subjects:
Bone marrow
CT imaging
Diagnosis
Magnetic resonance imaging
Medical prognosis
Methods
Multiple myeloma
Patients
PET imaging
Plasma
Review
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Summary:Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start treatment. Low-dose whole-body computed tomography (CT) is the modality of choice for the initial assessment, and dual-energy CT is a developing technique with the potential for detecting non-lytic marrow infiltration and evaluating the response to treatment. Magnetic resonance imaging (MRI) is more sensitive and specific than 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of small focal lesions and diffuse marrow infiltration. However, FDG-PET/CT is recommended as the modality of choice for follow-up. Recently, diffusion-weighted MRI has become a new technique for the quantitative assessment of disease burden and therapy response. Although not widespread, we address current proposals for structured reporting to promote standardization and diminish variations. This review provides an up-to-date overview of MM imaging, indications, advantages, limitations, and recommended reporting of each technique. We also cover the main differential diagnosis and pitfalls and discuss the ongoing controversies and future directions, such as PET-MRI and artificial intelligence.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13010264