scholarly journals Learning curves in radiological reporting of whole-body MRI in plasma cell disease: a retrospective study

Author(s):  
Davide Negroni ◽  
Alessia Cassarà ◽  
Alessandra Trisoglio ◽  
Eleonora Soligo ◽  
Sara Berardo ◽  
...  

Abstract Background The plasma cell disease is been studying by the whole-body MRI technology. However, the time requested to learn this radiological technique is unknown. Purpose To esteem, quantitatively and qualitatively, the essential time to learn the whole-body MRI diffusion-weighted imaging with background body signal suppression in patients with plasma cell disease. Materials and methods Between January 2015 and February 2017, three readers in-training with different levels of experience examined the anonymised and randomised whole-body MRI images of 52 patients with a diagnosis of plasma cell disease and analysed their morphological (T1w, T2w with and without fat suppression) and functional sequences. Reports of an expert radiologist were considered the standard of reference. Images were analysed in two sessions, during which each reader was timed. Readers reported the number of segments with lesions and staged the disease using the Durie–Salmon PLUS staging system. Weighted Cohen’s ĸ and Z-test were used to compare the trainees’ reports with those of the expert radiologist, and learning curves were drawn up to show changes between the two sessions. Results Weighted Cohen’s ĸ of number of lesioned segments increased from 0.536 ± 0.123 to 0.831 ± 0.129 (Prob > Z under 0.005), thus approaching the goal of ĸ > 0.8. Trainees reached the level of experienced radiologist in terms of time by the 33rd patient. Agreement concerning the Durie–Salmon PLUS increased from 0.536 ± 0.123 to 0.831 ± 0.129 (Prob > Z under 0.005). Conclusions The findings of this study demonstrate that whole-body MRI with DWIBS can be learned in about 80 reports and leads to a high level of inter-observer concordance when using the Durie–Salmon PLUS staging system.

2009 ◽  
Vol 9 ◽  
pp. S6
Author(s):  
J Hillengass ◽  
K Fechtner ◽  
C Heiss ◽  
T Hielscher ◽  
K Neben ◽  
...  

2014 ◽  
Vol 83 (7) ◽  
pp. 1222-1230 ◽  
Author(s):  
Maya B. Wolf ◽  
Fritz Murray ◽  
Kerstin Kilk ◽  
Jens Hillengass ◽  
Stefan Delorme ◽  
...  

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4966-4966
Author(s):  
Jens Hillengass ◽  
Kerstin Kilk ◽  
Karin Listl ◽  
Thomas Hielscher ◽  
Kai Neben ◽  
...  

Abstract Abstract 4966 Focal lesions (FL) and diffuse tumor cell infiltration detected by whole body MRI (WB-MRI) have been demonstrated to be of prognostic significance for predicting progression free and overall survival in patients with monoclonal plasma cell diseases. In this trial we have assessed 544 unselected and untreated patients: 138 with monoclonal gammopathy of undetermined significance (MGUS), 157 with smoldering myeloma (SMM), and 249 with multiple myeloma (MM). WB-MRI was performed on two identical 1. 5 Tesla MRI-scanners with body array curls. Assessment of FL was done by two experienced radiologists blinded to the diagnosis of the patients in consensus. We found focal lesions in 23. 9%, 34. 4%, and 80. 3% of patients with MGUS, SMM and MM, respectively, and a diffuse infiltration was detected in 38. 4%, 45. 9%, 71. 5% of the corresponding patients. The differences between MGUS, SMM and MM patients were statistically significant (p<0. 0001). The presence of FL as well as the presence of a diffuse infiltration was correlated with an increased plasma cell percentage in bone marrow (p<0. 0001) and monoclonal protein concentration (p=0. 001). Further categorization of the diffuse infiltration patterns in WB-MRI into minimal, moderate, severe and “salt&pepper” patterns, was able to identify a significant correlation between both M-protein and plasma cell percentage in bone marrow as well as age. In MGUS and SMM patients, FL were more often detected in patients with a diffuse background, while in MM patients, FL were present at the same rate across the diffuse infiltration subgroups. In summary bone marrow infiltration in WB-MRI is significantly different between stages of plasma cell disease and correlates with established markers of disease activity. Disclosures: No relevant conflicts of interest to declare.


2006 ◽  
Vol 16 (5) ◽  
pp. 1005-1014 ◽  
Author(s):  
Nadir Ghanem ◽  
Christian Lohrmann ◽  
Monika Engelhardt ◽  
Gregor Pache ◽  
Markus Uhl ◽  
...  

2012 ◽  
Vol 43 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Sherif A. Khedr ◽  
Mohamed A. Hassaan ◽  
Amro A. Shabana ◽  
Ayman H. Gaballah ◽  
Doha A. Mokhtar

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S692-S692
Author(s):  
Edwin Hayes ◽  
Lindsay Miranda ◽  
Anna-Kathryn Burch ◽  
Matthew Marcus ◽  
Helmut Albrecht ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046225
Author(s):  
Sarah Brown ◽  
Debbie Sherratt ◽  
Samantha Hinsley ◽  
Louise Flanagan ◽  
Sadie Roberts ◽  
...  

IntroductionMultiple myeloma (MM) is a plasma cell tumour with over 5800 new cases each year in the UK. The introduction of biological therapies has improved outcomes for the majority of patients with MM, but in approximately 20% of patients the tumour is characterised by genetic changes which confer a significantly poorer prognosis, generally termed high-risk (HR) MM. It is important to diagnose these genetic changes early and identify more effective first-line treatment options for these patients.Methods and analysisThe Myeloma UK nine OPTIMUM trial (MUKnine) evaluates novel treatment strategies for patients with HRMM. Patients with suspected or newly diagnosed MM, fit for intensive therapy, are offered participation in a tumour genetic screening protocol (MUKnine a), with primary endpoint proportion of patients with molecular screening performed within 8 weeks. Patients identified as molecularly HR are invited into the phase II, single-arm, multicentre trial (MUKnine b) investigating an intensive treatment schedule comprising bortezomib, lenalidomide, daratumumab, low-dose cyclophosphamide and dexamethasone, with single high-dose melphalan and autologous stem cell transplantation (ASCT) followed by combination consolidation and maintenance therapy. MUKnine b primary endpoints are minimal residual disease (MRD) at day 100 post-ASCT and progression-free survival. Secondary endpoints include response, safety and quality of life. The trial uses a Bayesian decision rule to determine if this treatment strategy is sufficiently active for further study. Patients identified as not having HR disease receive standard treatment and are followed up in a cohort study. Exploratory studies include longitudinal whole-body diffusion-weighted MRI for imaging MRD testing.Ethics and disseminationEthics approval London South East Research Ethics Committee (Ref: 17/LO/0022, 17/LO/0023). Results of studies will be submitted for publication in a peer-reviewed journal.Trial registration numberISRCTN16847817, May 2017; Pre-results.


Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1053
Author(s):  
Davide Ippolito ◽  
Teresa Giandola ◽  
Cesare Maino ◽  
Davide Gandola ◽  
Maria Ragusi ◽  
...  

The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol. Patients with biopsy-proven MM, who underwent a WBMRI with full-body coverage (from vertex to feet) were retrospectively enrolled. WBMRI images were independently evaluated by two expert radiologists, in terms of infiltration patterns (normal, focal, diffuse, and combined), according to location (the whole skeleton was divided into six anatomic districts: skull, spine, sternum and ribs, upper limbs, pelvis and proximal two-thirds of the femur, remaining parts of lower limbs) and lytic lesions number (<5, 5–20, and >20). The majority of patients showed focal and combined infiltration patterns with bone lesions predominantly distributed in the spine and pelvis. As skull and lower limbs are less frequently involved by focal bone lesions, excluding them from the standard MRI protocol allows to obtain a shorter protocol, maintaining a good diagnostic value.


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