{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:23:51Z","timestamp":1790987031385,"version":"4.1.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T00:00:00Z","timestamp":1445558400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T00:00:00Z","timestamp":1445558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We studied 188 patients with a suspected smoldering multiple myeloma (MM) who had undergone a positron emission tomography-computed tomography (PET-CT) scan as part of their clinical evaluation. PET-CT was positive (clinical radiologist interpretation of increased bone uptake and\/or evidence of lytic bone destruction) in 74 patients and negative in 114 patients. Of these, 25 patients with a positive PET-CT and 97 patients with a negative PET-CT were observed without therapy and formed the study cohort (\n                    <jats:italic>n<\/jats:italic>\n                    =122). The probability of progression to MM within 2 years was 75% in patients with a positive PET-CT observed without therapy compared with 30% in patients with a negative PET-CT; median time to progression was 21 months versus 60 months, respectively,\n                    <jats:italic>P<\/jats:italic>\n                    =0.0008. Of 25 patients with a positive PET-CT, the probability of progression was 87% at 2 years in those with evidence of underlying osteolysis (\n                    <jats:italic>n<\/jats:italic>\n                    =16) and 61% in patients with abnormal PET-CT uptake but no evidence of osteolysis (\n                    <jats:italic>n<\/jats:italic>\n                    =9). Patients with positive PET-CT and evidence of underlying osteolysis have a high risk of progression to MM within 2 years when observed without therapy. These observations support recent changes to imaging requirements in the International Myeloma Working Group updated diagnostic criteria for MM.\n                  <\/jats:p>","DOI":"10.1038\/bcj.2015.87","type":"journal-article","created":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T09:21:49Z","timestamp":1445592109000},"page":"e364-e364","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":92,"title":["Positron emission tomography-computed tomography in the diagnostic evaluation of smoldering multiple myeloma: identification of patients needing therapy"],"prefix":"10.1038","volume":"5","author":[{"given":"B","family":"Siontis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Dispenzieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M T","family":"Drake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Q","family":"Lacy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Buadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Dingli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Gonsalves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Gertz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S V","family":"Rajkumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2015,10,23]]},"reference":[{"key":"BFbcj201587_CR1","doi-asserted-by":"publisher","first-page":"3069","DOI":"10.1182\/blood-2014-09-568899","volume":"125","author":"SV Rajkumar","year":"2015","unstructured":"Rajkumar SV, Landgren O, Mateos MV . Smoldering multiple myeloma. Blood 2015; 125: 3069\u20133075.","journal-title":"Blood"},{"key":"BFbcj201587_CR2","doi-asserted-by":"publisher","first-page":"2582","DOI":"10.1056\/NEJMoa070389","volume":"356","author":"RA Kyle","year":"2007","unstructured":"Kyle RA, Remstein ED, Therneau TM, Dispenzieri A, Kurtin PJ, Hodnefield JM et al. Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma. N Engl J Med 2007; 356: 2582\u20132590.","journal-title":"N Engl J Med"},{"key":"BFbcj201587_CR3","doi-asserted-by":"publisher","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","volume":"15","author":"SV Rajkumar","year":"2014","unstructured":"Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos M-V et al. International Myeloma Working Group Updated Criteria for the Diagnosis of Multiple Myeloma. Lancet Oncol 2014; 15: e538\u2013e548.","journal-title":"Lancet Oncol"},{"key":"BFbcj201587_CR4","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1038\/leu.2010.60","volume":"24","author":"RA Kyle","year":"2010","unstructured":"Kyle RA, Durie BG, Rajkumar SV, Landgren O, Blade J, Merlini G et al. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia 2010; 24: 1121\u20131127.","journal-title":"Leukemia"},{"key":"BFbcj201587_CR5","doi-asserted-by":"publisher","first-page":"1764","DOI":"10.1056\/NEJMoa1300439","volume":"369","author":"MV Mateos","year":"2013","unstructured":"Mateos MV, San Miguel JF . Treatment for high-risk smoldering myeloma. N Engl J Med 2013; 369: 1764\u20131765.","journal-title":"N Engl J Med"},{"key":"BFbcj201587_CR6","doi-asserted-by":"publisher","first-page":"2586","DOI":"10.1182\/blood-2007-05-088443","volume":"110","author":"E Perez-Persona","year":"2007","unstructured":"Perez-Persona E, Vidriales MB, Mateo G, Garcia-Sanz R, Mateos MV, de Coca AG et al. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood 2007; 110: 2586\u20132592.","journal-title":"Blood"},{"key":"BFbcj201587_CR7","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1038\/leu.2010.60","volume":"24","author":"RA Kyle","year":"2010","unstructured":"Kyle RA, Durie BGM, Rajkumar SV, Landgren O, Blade J, Merlini G et al. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia 2010; 24: 1121\u20131127.","journal-title":"Leukemia"},{"key":"BFbcj201587_CR8","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1038\/leu.2012.296","volume":"27","author":"JT Larsen","year":"2013","unstructured":"Larsen JT, Kumar SK, Dispenzieri A, Kyle RA, Katzmann JA, Rajkumar SV . Serum free light chain ratio as a biomarker for high-risk smoldering multiple myeloma. Leukemia 2013; 27: 941\u2013946.","journal-title":"Leukemia"},{"key":"BFbcj201587_CR9","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1182\/blood-2007-08-108357","volume":"111","author":"A Dispenzieri","year":"2007","unstructured":"Dispenzieri A, Kyle RA, Katzmann JA, Therneau TM, Larson D, Benson J et al. Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma. Blood 2007; 111: 785\u2013789.","journal-title":"Blood"},{"key":"BFbcj201587_CR10","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1038\/leu.2012.237","volume":"27","author":"G Bianchi","year":"2013","unstructured":"Bianchi G, Kyle RA, Larson DR, Witzig TE, Kumar S, Dispenzieri A et al. High levels of peripheral blood circulating plasma cells as a specific risk factor for progression of smoldering multiple myeloma. Leukemia 2013; 27: 680\u2013685.","journal-title":"Leukemia"},{"key":"BFbcj201587_CR11","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1200\/JCO.2009.25.5356","volume":"28","author":"J Hillengass","year":"2010","unstructured":"Hillengass J, Fechtner K, Weber MA, Bauerle T, Ayyaz S, Heiss C et al. Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma. J Clin Oncol 2010; 28: 1606\u20131610.","journal-title":"J Clin Oncol"},{"key":"BFbcj201587_CR12","doi-asserted-by":"publisher","first-page":"1902","DOI":"10.1038\/leu.2014.75","volume":"28","author":"M Merz","year":"2014","unstructured":"Merz M, Hielscher T, Wagner B, Sauer S, Shah S, Raab MS et al. Predictive value of longitudinal whole-body magnetic resonance imaging in patients with smoldering multiple myeloma. Leukemia 2014; 28: 1902\u20131908.","journal-title":"Leukemia"},{"key":"BFbcj201587_CR13","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1038\/nrclinonc.2012.128","volume":"9","author":"SV Rajkumar","year":"2012","unstructured":"Rajkumar SV, Merlini G, San Miguel JF . Redefining myeloma. Nat Rev Clin Oncol 2012; 9: 494\u2013496.","journal-title":"Nat Rev Clin Oncol"},{"key":"BFbcj201587_CR14","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/bjh.12346","volume":"162","author":"JC Regelink","year":"2013","unstructured":"Regelink JC, Minnema MC, Terpos E, Kamphuis MH, Raijmakers PG, Pieters-van den Bos IC et al. Comparison of modern and conventional imaging techniques in establishing multiple myeloma-related bone disease: a systematic review. Br J Haematol 2013; 162: 50\u201361.","journal-title":"Br J Haematol"},{"key":"BFbcj201587_CR15","doi-asserted-by":"crossref","unstructured":"Zamagni E, Nanni C, Gay F, Pezzi A, Bell\u00f2 M, Rambaldi R et al The presence of FDG PET\/CT focal, not osteolytic, lesion(s) identifies a sub-group of patients with smoldering multiple myeloma with high-risk of progression into symptomatic disease. Blood (ASH Annual Meeting Abstract) 2014; 124: A3371.","DOI":"10.1182\/blood.V124.21.3371.3371"}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/bcj201587.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/bcj201587","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/bcj201587.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T05:03:23Z","timestamp":1672895003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/bcj201587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,23]]},"references-count":15,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2015,10]]}},"alternative-id":["BFbcj201587"],"URL":"https:\/\/doi.org\/10.1038\/bcj.2015.87","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,23]]},"assertion":[{"value":"2 September 2015","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2015","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"SK has obtained research support for clinical trials from Celgene, Millennium, Novartis, Janssen and Sanofi. AD has received research support for clinical trials from Pfizer, Jannsen, Millenium, Alnylam and Celgene. The remaining authors declare no conflict of interest. MAG has received research support from ISIS and Prothena, and honoraria from Celgene, Millennium Pharmaceuticals and Novartis. None of these are related to the article. The other authors declare no conflict of financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}