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Insights into Imaging

Table 5 New imaging techniques in the Durie-Salmon PLUS staging system [22]

From: The role of magnetic resonance imaging in the evaluation of bone tumours and tumour-like lesions

Durie-Salmon PLUS staging system

Classification

New imaging (MRI and/or FDG PET)

 MGUS

All negative (normal marrow)

 Stage IA

(Smouldering or indolent)

Can have single plasmacytoma and/or

Limited disease (definition evolving)

Multiple myeloma

 IB

<5 focal lesions; mild diffuse disease

 IIA/B

5-20 focal lesions; moderate diffuse disease

 IIIA/B

>20 focal lesions; severe diffuse disease

  1. MGUS: Monoclonal gammopathy of undetermined significance
  2. A: serum creatinine <2.0 mg/dl; no extramedullary disease (EMD)
  3. B: serum creatinine >2.0 mg/dl; extramedullary disease (EMD)
  4. Mild difuse disease: micronodular pattern; moderate disease: diffuse low signal intensity on T1WI, but contrast between the bone marrow and disk remains; severe disease: contrast between bone marrow and disk is lost or inverted (bone marrow shows a signal intensity equal or inferior to that of the disk on T1WI)
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