Whole-Body Imaging of Multiple Myeloma: Diagnostic Criteria.

Multiple myeloma (MM) is a clonal plasma cell proliferative disorder characterized by primary infiltration of bone marrow and excessive production of abnormal immunoglobulin. This disease is the second most common hematologic malignancy (after lymphoma), and its spectrum of characteristic features are widely known by the acronym CRAB (hypercalcemia, renal impairment, anemia, and bone lesions). Traditionally, the diagnosis and treatment of MM have been triggered by clear end-organ damage. However, owing to recently introduced treatment options that can extend patient survival and the increasing recognition of biomarkers that can be used to identify patients at high risk of progression to active disease, the diagnostic criteria have been revised. Bone disease is one of the most prominent features of MM, and imaging has an important role in diagnosis and follow-up, with each whole-body imaging modality having different indications in distinct disease situations. Skeletal survey has been the standard imaging procedure used during the past decade, but it should no longer be used unless it is the only option. Whole-body low-dose CT is a reasonable and cost-effective initial imaging approach. Whole-body MRI is the most sensitive technique for detecting bone involvement and assessing painful complications. PET/CT is the best tool for evaluating treatment response. The importance of radiologists has increased in this scenario. Therefore, to properly assist hematologists and improve the care of patients with MM, it is essential that radiologists know the updated diagnostic criteria for MM, indications for and limitations of each imaging option, and recommendations for follow-up. Online supplemental material is available for this article. ©RSNA, 2019.

EXIT25 - Executive interview applied to a cognitively healthy elderly population with heterogeneous educational background.

Education interferes with the performance in most cognitive tests, including executive function assessment. OBJECTIVE: To investigate the effects of education on the performance of healthy elderly on the Brazilian version of the Executive Interview (EXIT25). METHODS: The EXIT25 was administered to a sample of 83 healthy elderly. The subjects were also submitted to the Mini-Mental State Examination (MMSE), a delayed recall test, clock drawing and category fluency (animals/min) tests in order to rule out cognitive impairment. The Geriatric Depression Scale (GDS) was employed to exclude clinically-relevant depressive symptoms. The total sample was divided into three groups according to educational level: G1 (1-4 years), G2 (5-8 years) and G3 (>8 years). RESULTS: The mean values for age, educational level, MMSE and EXIT25 scores of all subjects were 72.2, 7.5, 27.6 and 6.9, respectively. The scores on the EXIT25 for each group were: G1=8.3, G2=5.9 and G3=5.8. There was a statistical difference between the performance of G1 and the other two groups on the EXIT25. CONCLUSIONS: The Brazilian version of the EXIT25 proved straightforward to administer. The performance of this sample of healthy elderly on the test was significantly influenced by educational level.

O nível educacional interfere no desempenho da maioria dos testes cognitivos incluindo os de função executiva. OBJETIVO: Investigar os efeitos da educação no desempenho de idosos saudáveis na versão brasileira do teste de funções executivas (EXIT25). MÉTODOS: O EXIT25 foi administrado a uma amostra de 83 idosos saudáveis. Os indivíduos foram também submetidos ao Mini-Exame de Estado Mental (MEEM), a um teste de evocação, ao desenho do relógio e ao teste de fluência de categorias (animais/min) com a função de excluir prejuízos cognitivos. A Escala de Depressão Geriátrica foi aplicada para excluir sintomas de depressão clinicamente relevante. O total da amostra foi dividido em três grupos de acordo com o nível educacional: G1 (1­4 anos), G2 (5­8 anos) e G3 (>8 anos). RESULTADOS: As médias de idade, nível educacional, MEEM e EXIT25 de todos os indivíduos foram respectivamente de 72,2; 7,5; 27,6 e 6,9. Os valores do EXIT25 para cada grupo foram: G1=8,3; G2=5,9 e G3=5,8. Houve diferença estatística entre o desempenho de G1 e os outros dois grupos no EXIT25. CONCLUSÕES: A versão brasileira do EXIT25 provou ser de fácil administração. O desempenho da amostra de idosos examinada foi significativamente influenciada pelo nível educacional.