Carmelo Cicciò MD, Abstract Co-Author: Nothing to Disclose

Ettore Squillaci MD, Abstract Co-Author: Nothing to Disclose

Francesca Bolacchi, Presenter: Nothing to Disclose

Costantino Del Giudice MD, Abstract Co-Author: Nothing to Disclose

Orazio Schillaci MD, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

To asses the value of 3T Whole-Body Magnetic Resonance Imaging (WB-MRI) for lesions detection and staging of multiple myeloma (MM) patients in comparison with Skeletal Survey (SS) and 18F-FDG PET-CT (PET-CT).

Forty-four patients with previously diagnosed MM underwent 3T WB-MRI (Philips Achieva, Best, The Netherlands) and Whole-Body [18F]-2-Fluoro-2-deoxy-D-glucose (FDG) PET/CT (GE Discovery ST 64) for pre-treatment staging within 30 days after conventional SS. WB-MRI was performed using a Quadrature Body Coil (QBC) for radiofrequency (RF) signal emission and reception with a dedicated rolling table patient support with multi-stacks approach. Morphological (T1W, T2W-STIR), Diffusion-Weighted Imaging With Background Suppression (DWIBS) and Contrast-enhanced 3D FFE T1W THRIVE 3D sequences were performed. WBMR images were evaluated in consensus by two radiologists while the PET/CT images by one radiologist and one nuclear physician. Disease staging was evaluated according to Durie and Salmon PLUS criteria.

A total of 176 malignant (152 focal/24 diffuse pattern) and 62 benign bone lesions were detected. WB-MRI reached a sensitivity of 94% (166/176) with a specificity of 89 % (55/62) and a diagnostic accuracy of 93%. Sensitivity, specificity and diagnostic accuracy of PET-CT and SS were 91%, 81%, 90% and 59%, 48% 58%, respectively. Extra-bone involvement was detected in 9 patients. WB-MRI missed 9 lesions at rib cage and skull.

WB-MRI presents an high diagnostic accuracy for staging MM patients. In the care of patients with newly diagnosed myeloma, staging with WB MRI-DWI did not result in stage underestimation compared to FDG PET/CT.

The present study demonstrated the role of pre-treatment PET/CT and WB-MRI staging in patients with multiple myeloma, showing advantages and disadvantages of the two imaging methods.

Cicciò, C, Squillaci, E, Bolacchi, F, Del Giudice, C, Schillaci, O, Simonetti, G, Pretreatment Staging of Multiple Myeloma Patients: 3 T Whole-Body MRI vs 18F-FDG PET/CT.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005998.html