Aims and objectives
Myeloma is a debilitating cancer,
with 5540 new patients and 2928 death each year in the UK.
It is characterisedby the clonal proliferation of plasma cells within the bone marrow resulting in significant bone pain,
a low blood count and high calcium levels,
affecting patients’ quality of life . Advanced imaging techniques including whole-body magnetic resonance imaging (WB-MRI),
whole-body computed tomography (WB-CT) or 18F-fluorodeoxyglucose positron emission...
Methods and materials
A retrospective study was performed following IRB approval.25 newly diagnosed myeloma patients (12 male; mean±SD = 61±10 years) underwent simultaneous 18F-FDG PET/CT and WB-MRI prior to treatment.
Inclusion criteria were clinical or biochemical suspicion of multiple myeloma,
no contraindication to either contrast enhanced WB-MRI or 18F-FDG PET/CT,
no previous chemotherapy or radiotherapy,
and a maximum 2monthinterval between WB-MRI and PET/CT with no interval treatment. PET/CT acquisition:...
Association was noted between SUV max and ADC skewness (r=-0.51,
but not SUV max and FF.
A number of ADC and FF parameters were also correlated e.g.
ADC mean & FF mean (r=-0.64,
p<0.001); ADC mean & FF skewness (r=0.58,
No significant associations were noted between SUV,
or FF with percentage bone marrow infiltration.
Quantitative parameters e.g.
standardised uptake value (SUV),
apparent diffusion coefficient (ADC) and fat fraction (FF) may enable more accurate assessment of plasma cell infiltration and bone marrow composition in newly diagnosed myeloma. The use of water-fat imaging techniques such as the two-point or multi point Dixon technique permits the calculation of fat fraction data and hence quantitative assessment using the simple equation FF = fat/(fat+water) .
It is postulated that,
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International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.
2014;15(12):e538-48. 3.Zamagni E,
A prospective comparison of 18F-fluorodeoxyglucose positron emission...