Christoph Weber MD, Presenter: Nothing to Disclose

Hannah Hentschel, Abstract Co-Author: Nothing to Disclose

Thorsten Derlin, Abstract Co-Author: Nothing to Disclose

Nikolaus Kröger MD, PhD, Abstract Co-Author: Nothing to Disclose

Gerhard B. Adam MD, Abstract Co-Author: Nothing to Disclose

Peter Bannas MD, Abstract Co-Author: Nothing to Disclose

To determine the diagnostic value of whole body MRI (WBMRI) in staging of patients with multiple myeloma (MM) after stem cell transplantation (SCTX) in complete or partial remission (CR, PR) in comparison to MRI of the spine alone

40 patients with MM were examined twice on a 1.5T scanner with a WBMRI protocol using fat-suppressed STIR, T1-FEE, and contrast-enhanced fat-suppressed T1 sequences. Mean time between baseline and follow-up WBMRI after SCTX was 1.3y (0.2-2.8y). WBMRI findings of involvement of the skeletal system and extraosseous relapse were analyzed between the groups and correlated to an isolated analysis of axial skeleton MRI in analogy to the Salmon Durie Plus Staging System. Two blinded readers independently evaluated baseline and follow-up WBMRI .

At baseline WBMRI 20 patients were in CR and 20 patients in PR. Baseline and follow-up WBMRI of 9 of all 40 patients (23%) revealed no pathological findings (CR group: 6/20 (30%); PR group 3/20 (15%)). Follow-up WBMRI revealed regredient findings of bone involvement in 5 of 40 patients (13%) (CR group: 1/20 (5%), PR group 4/20 (20%)). 12 of 40 patients (30%) had no change of bone involvement (CR group: 8/20 (40%), PR 4/20 (20%)). 14 of 40 patients (35%) had progressive bone involvement. Progredient findings were located in the axial skeleton in 1/14 patients (7%), in 9/14 patients (64%) both in the axial and extra-axial skeleton and in 4/14 patients (28%) outside the axial skeleton. In 12 of 14 patients (86%) findings were osseous, in 2 of 14 patients (14%) findings were osseous as well as extra-osseous.

For only 1 of 14 patients (7%) with progressive disease MRI of the spine (Salmon and Durie Plus staging) would have been sufficient to detect progression. In 8 of 14 cases WBMRI would have been necessary to discover the whole extent of pathological findings. For 5 patients WBMRI was necessary to detect progressive disease at all. These findings demonstrate the potential of WBMRI as imaging modality of choice for an accurate staging of MM after SCTX.

WBMRI based staging after SCTX in patients with MM is a significant prognostic tool and therefore recommended for post-therapeutic monitoring.

Weber, C, Hentschel, H, Derlin, T, Kröger, N, Adam, G, Bannas, P, Whole-Body MRI for Staging of Patients with Multiple Myeloma in Complete or Partial Remission after Stem Cell Transplantation.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11011194.html