PROGNOSTIC-SIGNIFICANCE OF MAGNETIC-RESONANCE-IMAGING IN PATIENTS WITH ASYMPTOMATIC MULTIPLE-MYELOMA

Purpose: To assess the prognostic significance of magnetic resonance ( MR) imaging in patients with newly diagnosed asymptomatic multiple mye loma. Patients and Methods: Thirty-eight consecutive patients with asy mptomatic myeloma of low tumor mass and negative skeletal surveys unde rwent MR imaging of the thoracic and lumbosacral spine. The presence a nd patterns of marrow involvement were correlated with standard labora tory parameters and time to disease progression. Results: Nineteen pat ients (50%) had evidence of marrow involvement at spinal MR imaging. M R patterns of marrow involvement were classified as diffuse (five pati ents), variegated (nine), and focal (five). Patients with abnormal MR imaging studies required therapy after a median of 16 months, versus 4 3 months for those with normal MR studies (P < .01). Conclusion: Abnor mal marrow patterns were present in half of patients with asymptomatic myeloma. An abnormal MR study of the spine identified asymptomatic pa tients who were likely to require treatment earlier than those with a normal MR study. A normal MR pattern provided additional justification to defer institution of chemotherapy. However, MR imaging remains an investigational tool to stage patients with multiple myeloma until mor e data are accumulated. (C) 1995 by American Society of Clinical Oncol ogy.