Multiple Myeloma

  • Andrea Baur-Melnyk
  • Melvin D’Anastasi
Part of the Medical Radiology book series (MEDRAD)


Multiple myeloma is a malignant bone marrow neoplasia in which a monoclonal strain of atypical plasma cells proliferates and typically secretes paraproteins. It typically affects the elderly population with a peak incidence in the eighth decade. The atypical plasma cells are distributed in the bone marrow either focally or in a diffuse manner and may result in bone destruction, but may also occur in soft tissue. Bone marrow aspirates or bone marrow biopsies are essential for the diagnosis. Due to various therapeutic options and the large variability in survival, the sensitive detection of myeloma involvement of the skeleton is mandatory to enable accurate disease staging. Various imaging methods are employed in assessing the disease burden in multiple myeloma. The following chapter reviews the findings in multiple myeloma in conventional radiography, computed tomography (CT), positron-emission tomography (PET)/CT, and magnetic resonance imaging (MRI) and compares the various methods. Whole-body MRI is superior to the skeletal survey and whole-body multidetector CT (MDCT). On the other hand, MDCT is the method of choice for displaying osteolytic lesions and determining fracture risk. PET-CT has a high sensitivity and specificity in detecting myeloma involvement and has been shown to be more sensitive than other modalities for detecting extramedullary sites of disease. The increased sensitivity of these imaging techniques has led to further refinement of the classic Durie and Salmon staging system. We review the role of the various imaging methods in the staging, assessment of prognosis, and evaluation of relapse/response to therapy in multiple myeloma. Knowledge of the use and limitations of the various imaging modalities, imaging findings, staging, and treatment-related changes is essential for the accurate assessment of the disease burden in multiple myeloma by the radiologist.


Multiple Myeloma Focal Lesion Osteolytic Lesion Percutaneous Vertebroplasty Solitary Plasmacytoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Institut für Klinische Radiologie, Klinikum der Universität München-GroßhadernMünchenGermany

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