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Computed tomography assessment of bone lesions in patients with POEMS syndrome

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To describe the imaging findings on computed tomography (CT) and skeletal survey (SS) in patients with POEMS syndrome.

Methods

We retrospectively reviewed, with institutional review board approval, the dysproteinemia database at our institution for patients with new diagnosis of POEMS syndrome between January 1998 and December 2008. Twenty-four patients were identified with PET/CT or CT and had skeletal survey (SS) available for review.

Results

Twenty-four patients were included in the study group with median age of 47 years. All CTs demonstrated at least one sclerotic lesion. The most common pattern was multiple small lesions, with 18 patients (75 %) having at least 5 lesions less than 1 cm. The larger lesions had a central lytic component and were FDG avid. SS had a false negative rate of 36 % (8 patients). Serial CT after treatment showed a decrease in size and number of sclerotic lesions in 53 % of cases (13 patients), the majority showing increased sclerosis. Two patients had complete resolution of sclerotic lesions.

Conclusions

CT identified sclerotic lesions in all study patients with POEMS syndrome, the majority being less than 1 cm in size, which were not identified radiographically. CT may demonstrate increased sclerosis or even resolution of sclerotic lesions corresponding to treatment response.

Key Points

• CT has high sensitivity in identifying sclerotic lesions in POEMS syndrome

• Most common CT patterns are multiple, less than 1 cm, sclerotic lesions

• Larger lesions have lytic centres and sclerotic margins

• Skeletal surveys may have a false negative rate of 36 %

• Treatment response includes increased sclerosis, decrease in size or resolution of lesions

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Acknowledgements

The authors wish to thank Dr Paul Frohnert for his help with data collection and Mr Peter McAnally for help with manuscript preparation. The scientific guarantor of this publication is Katrina Glazebrook. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, observational, performed at one institution

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Authors and Affiliations

  1. Mayo Clinic, 200 First St SW, Rochester, MN, 55902, USA

    K. Glazebrook, Adam Johnson, S. Leng & A. Dispenzieri

  2. Hematology Division, Hospital Regional Rafael Hernandez, David, Chiriqui, Panama

    Francis L. Guerra Bonilla

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  1. K. Glazebrook
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  2. Francis L. Guerra Bonilla
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  3. Adam Johnson
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  4. S. Leng
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  5. A. Dispenzieri
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Correspondence to K. Glazebrook.

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Glazebrook, K., Guerra Bonilla, F.L., Johnson, A. et al. Computed tomography assessment of bone lesions in patients with POEMS syndrome. Eur Radiol 25, 497–504 (2015). https://doi.org/10.1007/s00330-014-3428-y

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  • DOI: https://doi.org/10.1007/s00330-014-3428-y

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