Compared with standard whole-body magnetic resonance imaging (WBMRI), a short WBMRI protocol may reduce the length of MRI tests, while maintaining high sensitivity and specificity, among patients with multiple myeloma (MM) undergoing diagnostic testing, according to research published in Diagnostics.
MM is the second-most common hematologic cancer, following non-Hodgkin lymphomas, and is characterized by bone disease, with as many as 4 in 5 MM cases presenting with osteolytic lesions. Bone disease in MM is, furthermore, associated with both increased morbidity and increased mortality.
The high occurrence and significance of bone disease in MM necessitates the close evaluation of skeletal involvement where MM is suspected. In these cases, WBMRI is frequently used to determine the presence of bone disease, although this technique is associated with high cost and is not always available. The duration of WBMRI may have negative implications for patient comfort.
Short-protocol WBMRI, which is less time consuming for assessing bone disease where MM is suspected, may be a promising substitute for whole WBMRI. For this retrospective study, researchers evaluated the effectiveness of short WBMRI for assessing bone marrow involvement among patients with MM.
Overall, data from 64 patients with biopsy-verified MM who had previously undergone whole WBMRI were included in this study. There were 2 radiologists who evaluated the WBMRI images for infiltration patterns by location, using a predefined short WBMRI scoring system.
Most included patients with infiltration showed these patterns only in the spine and pelvic regions, suggesting that the skull and lower extremities are less likely to be infiltrated by focal bone lesions. The short WBMRI scoring system showed sensitivity and specificity of 89.8% and 66.7%, respectively.
“In conclusion, a short WBMRI protocol, excluding the anatomical regions of the skull and the lower extremities, could represent a reliable diagnostic imaging tool for the evaluation of MM patients, shortening the duration of MRI examination, maintaining an overall good sensitivity, specificity, and diagnostic accuracy and also reducing the patient’s potential discomfort,” the authors wrote.
Ippolito D, Giandola T, Maino C, et al. Diagnostic value of whole-body MRI short protocols in bone lesion detection in multiple myeloma patients. Diagnostics (Basel). 2021;11(6):1053. doi:10.3390/diagnostics11061053