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ORIGINAL ARTICLE /Musculoskeletal imaging
Comparison of bone lesion distribution between prostate cancer and multiple myeloma with whole-body MRI
Magnetic resonance imaging (MRI); Whole-body MRI; Prostate cancer; Multiple myeloma
a Department of Radiology, Institut de Recherche expérimentale et Clinique (IREC), cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), 1200 Brussels,
b Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, 1011 Lausanne, Switzerland
c Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCLouvain, 1200 Brussels, Belgium
d Department of Radiology, Faculté de Médecine de Montpellier/Nîmes, Hôpital Lapeyronie, 34000 Montpellier, France
Purpose: To assess the distribution of bone lesions in patients with prostate cancer (PCa) and those with multiple myeloma (MM) using whole-body magnetic resonance imaging (MRI); and to assess the added value of four anatomical regions located outside the thoraco-lumbo-pelvic area to detect the presence of bone lesions in a patient-based perspective.
Results: In patients with PCa, there was a cranio-caudal increasing prevalence of metastases (22% [11/50] in the humeri and cervical spine to 60% [30/50] in the pelvis). When the thoraco-lumbo-pelvic region was not involved, the prevalence of involvement of the cervical spine, proximal humeri, ribs, or proximal femurs was 0% in patients with PCa and ≥ 4% (except for the cervical spine, 0%) in those with MM.
∗ Corresponding author. E-mail address: [email protected] (F.E. Lecouvet).
Conclusion: In patients with PCa, there is a cranio-caudal positive increment in the preva-lences of metastases and covering the thoraco-lumbo-pelvic area is sufficient to determine the metastatic status of a patient with PCa. In patients with MM, there is added value of screening all regions, except the cervical spine, to detect additional lesions.
© 2019 Societ´e´ franc¸aise de radiologie. Published by Elsevier Masson SAS. All rights reserved.
The ability to accurately detect bone involvement has a major importance in patients with ‘‘osteophilic’’ cancers like breast or prostate cancer (PCa) and in hematologic malignancies involving bones, like multiple myeloma (MM). Indeed, the detection of bone metastases (BM) or focal osteolytic lesions in MM, at the time of diagnosis or dur-ing the follow-up, has an impact on patient management. Most frequently, the presence of bone lesions leads to the introduction or adaptation of systemic therapy [1,2] or more specific treatments [3—7].
In patients with cancers at risk for skeletal dissemination, the search for BM has been performed for decades using bone scintigraphy (BS) . In patients with MM, the radiographic skeletal survey has been used to detect characteristic lytic bone lesions . However, whole-body magnetic resonance imaging (MRI) allows now coverage of the whole skeleton similar to BS and radiographic skeletal survey, and has sev-eral advantages [9—12].