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Leukemia & Lymphoma Volume 57, 2016 - Issue 5
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Original Articles: Clinical

Bone marrow abnormalities and early bone lesions in multiple myeloma and its precursor disease: a prospective study using functional and morphologic imaging

Manisha BhutaniMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA; ;Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA;
,
Baris TurkbeyMolecular Imaging Program, CCR, NCI, NIH, Bethesda, MD, USA;
,
Esther TanMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Neha KordeMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA; ;Memorial Sloan-Kettering Cancer Center, New York, NY, USA;
,
Mary KwokMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Elisabet E. ManasanchMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA; ;The University of Texas MD Anderson Cancer Center, Houston, TX, USA;
,
Nishant TagejaMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Sham MailankodyMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Mark RoschewskiMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Marcia MulquinMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Ashley CarpenterMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Elizabeth LampingMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Alex R. MinterMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA;
,
Brendan M. WeissMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA; ;Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA;
,
Esther MenaMolecular Imaging Program, CCR, NCI, NIH, Bethesda, MD, USA;
,
Liza LindenbergMolecular Imaging Program, CCR, NCI, NIH, Bethesda, MD, USA;
,
Katherine R. CalvoHematology Section, DLM, CC, NIH, Bethesda, MD, USA
,
Irina MaricHematology Section, DLM, CC, NIH, Bethesda, MD, USA
,
Saad Z. UsmaniLevine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA;
,
Peter L. ChoykeMolecular Imaging Program, CCR, NCI, NIH, Bethesda, MD, USA;
,
Karen KurdzielMolecular Imaging Program, CCR, NCI, NIH, Bethesda, MD, USA;
&
Ola LandgrenMultiple Myeloma Section, Lymphoid Malignancies Branch, CCR, NCI, NIH, Bethesda, MD, USA; ;Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Correspondence[email protected]
 show all
Pages 1114-1121 | Received 08 Mar 2015, Accepted 31 Aug 2015, Published online: 07 Apr 2016
 
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Abstract

The incidence and importance of bone marrow involvement and/or early bone lesions in multiple myeloma (MM) precursor diseases is largely unknown. This study prospectively compared the sensitivity of several imaging modalities in monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM) and MM. Thirty patients (10 each with MGUS, SMM and MM) were evaluated with skeletal survey, [18F]FDG-PET/CT, [18F]NaF-PET/CT and morphologic dynamic contrast enhanced (DCE)-MRI. An additional 16 SMM patients had skeletal surveys and FDG-PET/CT. Among MGUS patients, DCE-MRI found only one focal marrow abnormality; other evaluations were negative. Among 26 SMM patients, five (19%) were re-classified as MM based on lytic bone lesions on CT and six had unifocal or diffuse marrow abnormality. Among MM, marrow abnormalities were observed on FDG-PET/CT in 8/10 patients and on DCE-MRI in nine evaluable patients. Abnormal NaF uptake was observed only in MM patients with lytic lesions on CT, providing no additional clinical information.

Acknowledgements

This research was supported by the Intramural Research Program of the NCI, NIH. Clinicaltrials.gov identifier: NCT01237054; NCT01572480. The abstract was accepted for general poster session at ASCO 2014 annual meeting, Chicago, IL.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1090572

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