TY - JOUR
T1 - Magnetic resonance imaging in the staging of solitary plasmacytoma of bone
AU - Moulopoulos, Lia A.
AU - Dimopoulos, Meletios A.
AU - Weber, Donna
AU - Fuller, Lillian
AU - Libshitz, Herman I.
AU - Alexanian, Raymond
PY - 1993
Y1 - 1993
N2 - Purpose: To assess prospectively the role of magnetic resonance (MR) imaging in the staging of patients with a solitary bone plasmacytoma (SBP). Patients and Methods: Twelve consecutive patients with an apparent SBP underwent MR imaging of both the primary tumor and the thoracic and lumbosacral spine to seek additional foci of marrow involvement that might have been undetected by standard skeletal survey. All patients received megavoltage irradiation (total dose, 40 Gy) to the primary lesion. Results: MR imaging of the thoracic and lumbosacral spine showed additional foci of marrow replacement in four of 1 2 patients, with signal characteristics identical to those of the primary tumor. In all four patients, the abnormal protein persisted at greater than 50% of the pretreatment value following radiation treatment. In contrast, the myeloma protein disappeared or was reduced by greater than 50% in five of the six patients with secretory disease and without additional marrow abnormalities. One of four patients progressed to multiple myeloma 10 months after diagnosis with new lesions on conventional radiographs in the same areas as detected previously by MR imaging. Conclusion; Four of 12 patients considered to have a SBP by standard criteria may have been understaged, because MR imaging showed additional marrow abnormalities consistent with myeloma. MR imaging of the spine may contribute to the initial staging of SBP, especially since some patients may be cured with radiotherapy.
AB - Purpose: To assess prospectively the role of magnetic resonance (MR) imaging in the staging of patients with a solitary bone plasmacytoma (SBP). Patients and Methods: Twelve consecutive patients with an apparent SBP underwent MR imaging of both the primary tumor and the thoracic and lumbosacral spine to seek additional foci of marrow involvement that might have been undetected by standard skeletal survey. All patients received megavoltage irradiation (total dose, 40 Gy) to the primary lesion. Results: MR imaging of the thoracic and lumbosacral spine showed additional foci of marrow replacement in four of 1 2 patients, with signal characteristics identical to those of the primary tumor. In all four patients, the abnormal protein persisted at greater than 50% of the pretreatment value following radiation treatment. In contrast, the myeloma protein disappeared or was reduced by greater than 50% in five of the six patients with secretory disease and without additional marrow abnormalities. One of four patients progressed to multiple myeloma 10 months after diagnosis with new lesions on conventional radiographs in the same areas as detected previously by MR imaging. Conclusion; Four of 12 patients considered to have a SBP by standard criteria may have been understaged, because MR imaging showed additional marrow abnormalities consistent with myeloma. MR imaging of the spine may contribute to the initial staging of SBP, especially since some patients may be cured with radiotherapy.
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U2 - 10.1200/JCO.1993.11.7.1311
DO - 10.1200/JCO.1993.11.7.1311
M3 - Article
C2 - 8315427
AN - SCOPUS:0027318198
SN - 0732-183X
VL - 11
SP - 1311
EP - 1315
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 7
ER -