Non-osseous imaging manifestations of plasma cell dyscrasias on PET/CT

Learning Objectives 1. Review clinical scenarios where imaging of plasma cell dyscrasias is employed. 2. Demonstrate the complementary value of combined anatomic and functional imaging in these scenarios. 3. Illustrate the range and most classic patterns of imaging findings.

Plasma cell dyscrasias comprise a diverse group of hematologic disorders that include multiple myeloma. Imaging plays an important role in identifying osseous and non-osseous disease and in guiding therapy selection. Most radiologic imaging focuses on osseous findings and can miss or misdiagnose non-osseous manifestations of the same disease process. Less commonly, plasma cell dyscrasias can present without any osseous findings. Functional imaging with PET can assist greatly in the proper diagnosis and staging of plasma cell dyscrasias. Here we review the basic clinical scenarios and imaging manifestations related to plasma cell dyscrasias. We show the range of and emphasize the patterns of non-osseous imaging findings that can be seen. Integrated PET/CT is useful to accurately identify non-osseous disease in multiple myeloma and related plasma cell dyscrasias