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Title: Screening whole spine Magnetic Resonance Imaging (MRI) in multiple myeloma.
Austin Authors: Wight, J ;Morris, E;Stillwell, A;Grant, B;Lai, H C;Irving, I
Affiliation: Austin health service, department of haematology; James Cook University, School of Medicine and Dentistry.
Issue Date: 14-Apr-2015
Publication information: Internal Medicine Journal; 45(7): 762-5
Abstract: Magnetic Resonance Imaging (MRI) is the most sensitive method for detecting focal spinal disease (FSD) in multiple myeloma (MM). It is unclear whether whole spine MRI (WS-MRI) should be employed as a screening test at diagnosis of MM.To determine the utility of screening WS-MRI at diagnosis of MM.A retrospective analysis of data from January 2008 to January 2013 at The Townsville Hospital was performed. At this centre, WS-MRI is used routinely in all newly diagnosed MM. The findings of WS-MRI in patients with and without an agreed guideline indication for WS-MRI were compared. Clinical predictors of FSD were determined.71 patients were included in the analysis. 44 (62%) had an agreed indication for MRI; 33 (75%) of these had FSD. Within this group, 17 required urgent intervention and 13 had spinal plasmacytomas. Within a second group without a guideline indication, 4 of 27 (15%) were found to have FSD on MRI - none required urgent intervention and or had plasmacytomas. 3 of 8 smouldering myeloma patients were reclassified as symptomatic myeloma by documenting lytic lesions not identified on plain film. The strongest predictors of FSD were back pain (p<0.001) and vertebral compression fracture (p=0.003).WS-MRI in patients without a guideline indication did not detect any lesions that threatened the spinal cord. WS-MRI is essential in those with guideline indications. WS-MRI is of benefit to patients with smouldering myeloma where documentation of lesions not seen on plain film will result in treatment rather than observation.
Gov't Doc #: 25870934
DOI: 10.1111/imj.12789
Journal: Internal Medicine Journal
Type: Journal Article
Subjects: MRI spine
Multiple Myeloma
Smouldering Myeloma
Appears in Collections:Journal articles

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