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 (https://www.nature.com/articles/bcj201778#auth-1), L A Moulopoulos (https://www.nature.com/articles/bcj201778#auth-2), S Delorme (https://www.nature.com/articles/bcj201778#auth-3), V Koutoulidis (https://www.nature.com/articles/bcj201778#auth-4), J Mosebach (https://www.nature.com/articles/bcj201778#auth-5), T Hielscher (https://www.nature.com/articles/bcj201778#auth-6), M Drake (https://www.nature.com/articles/bcj201778#auth-7), S V Rajkumar (https://www.nature.com/articles/bcj201778#auth-8), B Oestergaard (https://www.nature.com/articles/bcj201778#auth-9), N Abildgaard (https://www.nature.com/articles/bcj201778#auth-10), M Hinge (https://www.nature.com/articles/bcj201778#auth-11), T Plesner (https://www.nature.com/articles/bcj201778#auth-12), Y Suehara (https://www.nature.com/articles/bcj201778#auth-13), K Matsue (https://www.nature.com/articles/bcj201778#auth-14), N Withofs (https://www.nature.com/articles/bcj201778#auth-15), J Caers (https://www.nature.com/articles/bcj201778#auth-16), A Waage (https://www.nature.com/articles/bcj201778#auth-17), H Goldschmidt (https://www.nature.com/articles/bcj201778#auth-18), M A Dimopoulos (https://www.nature.com/articles/bcj201778#auth-19), S Lentzsch (https://www.nature.com/articles/bcj201778#auth-20), B Durie (https://www.nature.com/articles/bcj201778#auth-21) & E Terpos (https://www.nature.com/articles/bcj201778#auth-22)

Citatiion:

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