MRI Versus PET-CT in Symptomatic Patients With Multiple Myeloma
In patients with multiple myeloma, there seems to be no difference between using positron emission tomography–computed tomography (PET-CT) or magnetic resonance imaging (MRI) when detecting bone lesions at diagnosis, according to research published by Philippe Moreau, MD, of the Department of Hematology, University Hospital, Nantes, France, and colleagues in the Journal of Clinical Oncology.
The researchers conducted the prospective IMAJEM trial of 134 patients with multiple myeloma who received a combination of lenalidomide, bortezomib, and dexamethasone (RVD) with or without autologous stem cell transplantation, followed by lenalidomide maintenance. PET-CT and MRI were performed at diagnosis, after three cycles of RVD, and before maintenance therapy.
At diagnosis, MRI results were positive in 95% of patients, and PET-CT results were positive in 91% of patients. PET-CT became normal after three cycles of RVD in 32% of the patients with a positive evaluation at baseline, and progression-free survival was improved in this group. PET-CT normalization before maintenance therapy, which was described in 62% of the patients who were positive at baseline, was associated with better progression-free and overall survival.
The investigators concluded that PET-CT represents a “powerful tool” in evaluating the prognosis of patients with de novo myeloma.