Clinical Perspective

Practical radiology of plasmacytoma and multiple myeloma

Andrew du Toit, Lucille Wood, Peter Jacobs
South African Journal of Radiology | Vol 7, No 1 | a1416 | DOI: https://doi.org/10.4102/sajr.v7i1.1416 | © 2018 Andrew du Toit, Lucille Wood, Peter Jacobs | This work is licensed under CC Attribution 4.0
Submitted: 11 July 2018 | Published: 28 February 2003

About the author(s)

Andrew du Toit, Department of Haematology and Bone Marrow Transplant Unit incorporating the Searl Research Laboratory for Cellular and Molecular Biology, Constantiaberg Medi-Clinic, Cape Town, South Africa
Lucille Wood, Department of Haematology and Bone Marrow Transplant Unit incorporating the Searl Research Laboratory for Cellular and Molecular Biology, Constantiaberg Medi-Clinic, Cape Town, South Africa
Peter Jacobs, Department of Haematology and Bone Marrow Transplant Unit incorporating the Searl Research Laboratory for Cellular and Molecular Biology, Constantiaberg Medi-Clinic, Cape Town, South Africa

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Abstract

The traditional approach to diagnosis and staging in myeloma, based on haematologie and biochemical criteria, can be improved by inclusion of new forms of imaging. Standard radiographs have limited value but are still required because the majority of patients present with disease readily detected by this means. Also rapid extensive skeletal coverage is possible. Scintigraphy is limited by its poor sensitivity. CT is restricted to a region of interest but is however more accurate than DXA for demonstrating trabecular bone loss and density so that it emerges as valuable in the evaluation of therapy. MRI is currently the best choice for revealing marrow infiltration and, in ideal circumstances, the most sensible combination includes spine, pelvis and proximal femur MRI with skull, chest and rib X-rays. Furthermore MRI is finding a place in documenting prognosis when these individuals are treated.

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