Clinical Application of 18F-FDG-PET/CT in Multiple Myeloma

Kim, Jeong A

Abstract

Multiple myeloma (MM) is a plasma cell malignancy and is characterized by the presence of lytic bone disease causing severe bone pain, pathological fractures and spinal cord compression. Up to 80% of myeloma patients develop osteolytic lesions during the course of their disease. Appropriate use of imaging techniques is essential in the identification and characterization of the skeletal complications resulting from MM and in determination of the extent of intramedullary bone disease. Despite many weaknesses, conventional radiography still remains the standard for the staging procedure of newly diagnosed and relapsed myeloma patients. Magnetic resonance imaging (MRI) is recommended for MM patients with normal conventional radiography and for all patients with an apparently solitary plasmacytoma of bone. Urgent MRI is the diagnostic procedure of choice to assess suspected cord compression. Although Positron emission tomography/CT (PET/CT) is a useful method to assess the patient's response to the treatment and diagnose the extent of bone involvement and extramedullary disease in the patient, PET/CT is not recommended for routine use in myeloma patients. However, further studies are needed before the recommendation of using PET/CT as a standard tool in both diagnosis and follow-up of MM patients.