Skip to main content

Advertisement

SpringerLink
Log in

Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

To compare the diagnostic value of whole-body MRI versus radiological skeletal survey (RSS) in staging patients with plasma cell neoplasms (PCN) and to evaluate the possible therapeutic impact of the replacement of RSS by whole-body MRI. Fifty-four patients with PCN [multiple myeloma (MM), n=47; monoclonal gammopathy of unknown significance (MGUS), n=7] were studied by whole-body MRI and RSS in a monocenter prospective analysis from August 2002 to May 2004. The MRIs were performed using a rolling table platform “AngioSURF” for unlimited field of view with a 1.5-T system (Magnetom Sonata/Maestro Class, Siemens Medical Solutions, Erlangen, Germany). A coronal STIR sequence (TR5500-4230/TE102-94/TI160) was used for imaging of the different body regions, including the head, neck, thorax, abdomen, pelvis and upper and lower extremities. The RSS consisted of eight different projections of the axial and appendicular skeleton. In 41/54 (74%) patients, the results of the whole-body MRI and RSS were concordant. In 11/54 (20%) patients, both imaging techniques were negative. Bone involvement was observed in 30/54 (55%) patients; however, whole-body MRI revealed this more extensively than the RSS in 27/30 (90%) patients with concordant positive imaging findings. In 3/30 (10%) patients, both imaging techniques demonstrated a similar extent of bone marrow infiltration. In 10/54 (19%) patients, the whole-body MRI was superior to RSS in detecting bone marrow infiltration, whereas the RSS was negative. In 3/54 (6%) patients, the RSS was proven to be false positive by the clinical course, whereas the whole-body MRI was truly negative. Whole-body MRI is a fast and highly effective method for staging PCN patients by the use of a rolling table platform. Moreover, it is more sensitive and specific than RSS and reveals bone marrow infiltration and extensive disease more reliably. Therefore, whole-body MRI should be performed as an additional method of exactly staging PCN patients and - with more data in the field - may even prove to be an alternate and more sensitive staging procedure than RSS in PCN patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Munshi NC, Tricot G, Barlogie B. Plasma cell neoplasms. In: De Vita VT, Hellmann S, Rosenberg SA (eds) Cancer: principles and pratice of oncology, Lippincott, Philadelphia

  2. Durie BGM, Salmon S (1975) A clinical staging system for multiple myeloma. Cancer 36:842–854

    Article  PubMed  CAS  Google Scholar 

  3. Malpas JS, Caroll JJ (1995) Myeloma: clinical presentation and diagnosis. In: Malpass JS, Bergsagel DE, Kyle RA (eds) Myeloma: biology and management, Oxford Univeristy Press, New York, NY, p 169

    Google Scholar 

  4. Alexanian R, Dimopoulos MA (1995) Management of multiple myeloma. Semin Hematol 32:20–30

    PubMed  CAS  Google Scholar 

  5. Kyle RA (1984) Benign monoclonal gammopathy: a misnomer? JAMA 251:1849–1854

    Article  PubMed  CAS  Google Scholar 

  6. Swanson D (2001). Guideline: diagnosis and management of multiple myeloma. Br J Hematol 115:522–540

    Article  Google Scholar 

  7. Barlogie B, Shaughnessy J, Tricot G et al (2004) Treatment of multiple myeloma. Blood 103:20–32

    Article  PubMed  CAS  Google Scholar 

  8. Daffner RH, Lupetin AR, Dash N, Deeb ZL, Sefczek RJ, Schapiro RL (1986) MRI in the detection of bone marrow. AJR Am J Roentgenol 146:353–358

    PubMed  CAS  Google Scholar 

  9. Fruehwald F, Tscholakoff D, Schwaighofer B, Wicke L, Neuhold A, Ludwig H, Hajek PC (1988) MRI of the lower vertebral column in patients with multiple myeloma. Invest Radiol 23:193–199

    Article  PubMed  CAS  Google Scholar 

  10. Tertti R, Alanen A, Rhemes K (1995) The value of magnetic resonance imaging in screening myeloma lesions of the lumbar spine. Br J Haematol 91:658–660

    PubMed  CAS  Google Scholar 

  11. Altehoefer C, Ghanem N, Högerle S, Moser E, Langer M (2001) Comparative detectability of bone metastases and impact on therapy of magnetic resonance imaging and bone scintigraphy in patients with breast cancer. Eur J Radiol 40:16–23

    Article  PubMed  CAS  Google Scholar 

  12. Ghanem N, Altehoefer C, Högerle S, Schäfer O, Winterer J, Moser E, Langer M (2002) Comparative diagnostic value and therapeutic relevance of magnetic resonance imaging and bone marrow scintigraphy in patients with metastastic solid tumors of the axial skeleton. Eur J Radiol 43:256–261

    Article  PubMed  Google Scholar 

  13. Moulopoulus LA, Dimopoulus MA (1997). Magnetic resonance imaging of the bone marrow in hematologic malignancies. Blood 90:2127–2147

    PubMed  Google Scholar 

  14. Altehoefer C, Blum U, Bathmann J et al (1997) Comparative accuracy of magnetic resonance imaging and immunoscintigraphy for detection of bone marrow involvement in patients with malignant lymphoma. J Clin Oncol 15:1754–1760

    PubMed  CAS  Google Scholar 

  15. Rahmouni A, Divine M, Mathieu D et al (1993) Detection of multiple myeloma involving the spine: Efficacy of fat suppression and contrast-enhanced MR imaging. AJR Am J Roentgenol 160:1049–1052

    PubMed  CAS  Google Scholar 

  16. Vande Berg BC, Malghem J, Lecouvet FE, Maldague B (1998) Classification and detection of bone marrow lesions with magnetic resonance imaging. Skeletal Radiol 27:529–545

    Article  PubMed  CAS  Google Scholar 

  17. Dimopoulus MA, Moulopoulus LA, Datseris I, Weber D, Delasalle K, Gika D, Alexanian R (2000) Imaging of myeloma bone disease-implications for staging, prognosis and follow-up. Acta Oncol 39:823–827

    Article  PubMed  Google Scholar 

  18. Vande Berg BC, Michaux L, Lecouvet FE et al (1997) Nonmyelomatous monoclonal gammopathy: correlation of bone marrow MR images with laboratory findings and spontaneous clinical outcome. Radiology 202:247–251

    PubMed  CAS  Google Scholar 

  19. Baur A, Stäbler A, Nagel D et al (2002) Magnetic resonance imaging as a supplement for clinical staging system of Durie and Salmon? Cancer 95:1334–1345

    Article  PubMed  Google Scholar 

  20. Stäbler A, Baur A, Bartl R, Munker R, Lamerz R, Reiser MF (1996) Contrast enhancement and quantitative signal analysis in MR imaging of multiple myeloma: assessment of focal and diffuse growth patterns in marrow correlated with biopsies and survival rates. AJR Am J Roentgenol 167: 1029–1036

    PubMed  Google Scholar 

  21. Lecouvet FE, Malghem J, Michaux L et al (1999) Skeletal survey in advanced multiple myeloma: radiographic versus MR imaging survey. Br J Haematol 106:35–39

    Article  PubMed  CAS  Google Scholar 

  22. Walker RE, Eustace SJ (2001) Whole body magnetic resonance imaging: techniques, clinical indications, and future applications. Semin Musculoskel Radiol 5:5–20

    Article  CAS  Google Scholar 

  23. Schick F (2005) Whole-body MRI at high field: technical limits and clinical potential. Eur Radiol 15:946–959

    Article  PubMed  Google Scholar 

  24. Eustace S, Tello R, DeCarvalho V, Carey J, Melhem E, Yucel EK (1997). A comparison of whole-body turboSTIR MR imaging and planar 99m Tc-methylene diphosphonate scintigraphy in the examination of patients with suspected skeletal metastases. AJR Am J Roentgenol 169:1665

    Google Scholar 

  25. Steinborn MM, Heuck AF, Tiling R, Bruegel M, Gauger L, Reiser MF (1999) Whole-body bone marrow MRI in patients with metastastic disease to skeletal system. J Comput Assit Tomogr 23:123–129

    Article  CAS  Google Scholar 

  26. Ghanem N, Kelly T, Altehoefer C, et al (2004) Whole-body MRI in comparison to skeletal scintigraphy for detection of skeletal metastases in patients with solid tumors. Radiologe 44:864–874

    Article  PubMed  CAS  Google Scholar 

  27. Ghanem N, Altehoefer C, Winterer J, Högerle S, Ghanem-Wiesel C, Langer M (2002) Whole body MRI in staging cancer patients: A comparison with whole-body FDG-PET. Cancer Imaging 3:18–19

    Google Scholar 

  28. Daldrup-Link HE, Franzius C, Link TM, Laukamp D, Sciuk J, Jürgens H, Schober O, Rummeny EJ (2001) Whole-body MR imaging for detection of bone metastases in children and young adults: Comparison with skeletal scintigraphy and FDG-PET. AJR Am J Roentgenol 177: 229–236

    PubMed  CAS  Google Scholar 

  29. Lauenstein TC, Freudenberg LS, Goehde SC, Ruehm SG, Goyen M, Bosk S, Debatin JF, Barkhausen J (2002) Whole-body MRI using a rolling for detection of bone metastases. Eur Radiol 12:2091–2099

    PubMed  Google Scholar 

  30. Steinborn MM, Heuck AF, Tiling R, Bruegel M, Gauger L, Reiser MF (1999) Whole-body bone marrow MRI in patients with metastastic disease to skeletal system. J Comput Assit Tomogr 23:123–129

    Article  CAS  Google Scholar 

  31. Mentzel HJ, Kentouche K, Sauner D et al (2004) Comparison of whole-body STIR-MRI and 99mTc-methylene-diphosphonate scintigraphy in children with suspected multifocal bone lesions. Eur Radiol 14: 2297–2302

    Article  PubMed  Google Scholar 

  32. Kellenberger CJ, Miller SF, Khan M, Gilday DL, Weitzman S, Babyn PS (2004) Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children. Eur Radiol 14:1829–1841

    Article  PubMed  Google Scholar 

  33. Lizuka-Mikami M, Nagai K, Yoshida K et al (2004) Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin’s lymphoma by whole-body MRI: comparison with bone and 67 Ga scintigraphies. Eur Radiol 14:1074–1081

    Article  PubMed  Google Scholar 

  34. Schlemmer HP, Schäfer J, Pfannenberg C et al (2005) Fast whole-body assessment of metastatic disease using a novel magnetic resonance imaging system. Initial experiences. Invest Radiol 40:64–71

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    Nadir Ghanem, Christian Lohrmann, Gregor Pache, Markus Uhl, Ulrich Saueressig, Elmar Kotter & Mathias Langer

  2. Department of Hematology and Oncology, University Hospital Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    Monika Engelhardt

Authors
  1. Nadir Ghanem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian Lohrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Monika Engelhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gregor Pache
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Markus Uhl
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ulrich Saueressig
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elmar Kotter
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mathias Langer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nadir Ghanem.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ghanem, N., Lohrmann, C., Engelhardt, M. et al. Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey. Eur Radiol 16, 1005–1014 (2006). https://doi.org/10.1007/s00330-005-0055-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-005-0055-7

Keywords

Search

Navigation