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

Meletios A. Dimopoulos, Jens Hillengass, Saad Usmani, Elena Zamagni, Suzanne Lentzsch, Faith E. Davies, Noopur Raje, Orhan Sezer, Sonja Zweegman, Jatin Shah, Ashraf Badros, Kazuyuki Shimizu, Philippe Moreau, Chor Sang Chim, Juan José Lahuerta, Jian Hou, Artur Jurczyszyn, Hartmut Goldschmidt, Pieter Sonneveld, Antonio PalumboHeinz Ludwig, Michele Cavo, Bart Barlogie, Kenneth Anderson, G. David Roodman, S. Vincent Rajkumar, Brian G.M. Durie, Evangelos Terpos

Research output: Contribution to journalArticle

181 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)657-664
Number of pages8
JournalJournal of Clinical Oncology
Volume33
Issue number6
DOIs
StatePublished - Feb 20 2015

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Dimopoulos, M. A., Hillengass, J., Usmani, S., Zamagni, E., Lentzsch, S., Davies, F. E., Raje, N., Sezer, O., Zweegman, S., Shah, J., Badros, A., Shimizu, K., Moreau, P., Chim, C. S., Lahuerta, J. J., Hou, J., Jurczyszyn, A., Goldschmidt, H., Sonneveld, P., ... Terpos, E. (2015). Role of magnetic resonance imaging in the management of patients with multiple myeloma: A consensus statement. Journal of Clinical Oncology, 33(6), 657-664. https://doi.org/10.1200/JCO.2014.57.9961