Multiple myeloma CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] Shyam Patel [3]

Overview

CT scan does not have a major role in the diagnosis of disseminated multiple myeloma.[1] but low-dose whole-body CT may be helpful.[2][3] CT may also be useful for diagnosis of thrombotic-related complications and bony destruction from multiple myeloma. CT carries a high risk for radiation and should not be performed in pregnant patients.

CT Scan

  • CT scan does not have a major role in the diagnosis of disseminated multiple myeloma but low-dose whole-body CT may be helpful.[1][2][3]
  • CT in combination with PET imaging is highly useful for the diagnosis of osseous lesions. Osseous lytics will be fluorodeoxyglucose (FDG)-avid (hypermetabolic) on PET/CT. PET/CT is very sensitive for the diagnosis of lytic lesions of multiple myeloma.
  • CT may be useful in the detection of thrombotic complications related to multiple myeloma, including pulmonary embolism or mesenteric venous thrombosis.
  • CT may be useful to determine the extent of extra-osseous soft tissue component (plasmacytoma) in patients with a large disease burden.[1]
  • Contrast CT scans may lead to renal failure in multiple myeloma more frequently than otherwise. Hence, other modalities are preferred over CT scan for patients with multiple myeloma.[1]
  • CT carries a high risk for radiation exposure and subsequent malignancies. In contrast, MRI carries no radiation risk, and MRI may thus be more appropriate for some patients.
  • CT is less expensive than MRI but more expensive than X-ray. Clinical judgement should be used when decided which imaging modality to use.
  • CT scan should not be done in pregnant patients with multiple myeloma, given the risk of radiation exposure. Instead, MRI can be done.

References

  1. 1.0 1.1 1.2 1.3 Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015
  2. 2.0 2.1 Gerecke C, Fuhrmann S, Strifler S, Schmidt-Hieber M, Einsele H, Knop S (July 2016). "The Diagnosis and Treatment of Multiple Myeloma". Dtsch Arztebl Int. 113 (27–28): 470–6. doi:10.3238/arztebl.2016.0470. PMC 4973001. PMID 27476706.
  3. 3.0 3.1 Reisenbuckler C (2014). "Multiple myeloma and diagnostic imaging". Radiol Technol. 85 (4): 391–410, quiz 411–3. PMID 24614435.


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