MRI Useful in Detecting Bone Abnormalities in Multiple Myeloma

MRI Useful in Detecting Bone Abnormalities in Multiple Myeloma.

According to an article recently published in the Journal of Clinical Oncology, the use of magnetic resonance imaging (MRI) appears to be more effective than standard bone testing in detecting bone abnormalities in patients with multiple myeloma.

Multiple myeloma is a cancer of the blood that affects the plasma cells. Plasma cells are an important part of the immune system; they produce antibodies to help fight infection and disease. Multiple myeloma is characterized by an excess production of abnormal plasma cells. Symptoms include increased risk of bacterial infections and impaired immune responses.

Multiple myeloma also affects the bone in the majority of individuals. Due to several different biological processes, patients often experience low bone density, crowding of bone with cancerous cells, and, ultimately, bone fractures, which cause pain and immobility. The risk of bone complications also exist for patients with smoldering multiple myeloma; although this type of myeloma does not appear aggressive through standard tests, these patients may develop bone complications that could lead to fractures.

The fact that standard tests, such as X-rays or blood tests, do not appear to effectively identify bone complications until they are advanced puts patients with multiple myeloma at further risk of significant bone issues. Because early identification of bone abnormalities may help guide treatment for patients with multiple myeloma, researchers are evaluating the most effective ways to determine if bone abnormalities are present among patients with all stages of multiple myeloma.

Researchers from the University of Arkansas recently conducted a clinical trial to evaluate the effectiveness of MRI in detecting bone abnormalities among patients with multiple myeloma. This trial included 611 patients who were treated with two autologous stem cell transplants. Patients underwent standard metastatic bone surveys (MBS) and MRI to detect bone complications.

  • MRI detected 74% of focal lesions (FL)-an abnormality found at an isolated site-while MBS detected only 56%.
  • FLs were detected by MRI in 52% of patients who had a normal MBS result; FLs were detected by MBS in 20% of patients with normal MRI results.
  • Findings on MRI were associated with survival among these patients.

The researchers concluded that they recommend that, in addition to MBS, MRI be used routinely for staging, prognosis, and response assessment in myeloma. Patients with multiple myeloma may wish to speak with their physician regarding their individual risks and benefits of using MRI.

Reference: Walker R, Barlogie B, Haessler J, et al. Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications. Journal of Clinical Oncology. 2007; 25: 1121-1128.

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