Whole-body computed tomography versus conventional skeletal survey in patients with multiple myeloma: a study of the International Myeloma Working Group

The document discusses a study comparing the use of whole-body computed tomography (WBCT) and conventional skeletal survey (CSS) in patients with multiple myeloma (MM). ​ CSS has been the standard imaging technique for MM, but WBCT has recently been implemented into the diagnostic criteria. ​ The study found that WBCT identified significantly more sites of bone destruction than CSS. ​ In addition, more than 20% of patients with smoldering MM (SMM) according to CSS actually had active MM detectable with WBCT. ​ The presence of lytic bone lesions in WBCT was of borderline prognostic significance for SMM patients. ​ Based on this study and others, WBCT should be considered the current standard for the detection of osteolytic lesions in MM. ​

Key Points:

1. Conventional skeletal survey (CSS) has been the standard imaging technique for multiple myeloma (MM) for decades. ​​
2. Whole-body computed tomography (WBCT) has been implemented into the diagnostic criteria of MM. ​
3. WBCT identifies significantly more sites of bone destruction than CSS. ​
4. More than 20% of patients with smoldering MM (SMM) according to CSS have active MM detectable with WBCT. ​
5. The presence of lytic bone lesions in WBCT is of borderline prognostic significance for SMM patients. ​
6. WBCT (either CT alone or as part of a positron emission tomography-CT protocol) should be considered the current standard for the detection of osteolytic lesions in MM. ​

Authors:

J Hillengass, L A Moulopoulos, S Delorme, V Koutoulidis, J Mosebach, T Hielscher, M Drake, S V Rajkumar, B Oestergaard, N Abildgaard, M Hinge, T Plesner, Y Suehara, K Matsue, N Withofs, J Caers, A Waage, H Goldschmidt, M A Dimopoulos, S Lentzsch, B Durie & E Terpos

Citatiion:

Blood Cancer Journal (2017) 7, e599; doi:10.1038/bcj.2017.78