scholarly journals Whole-body magnetic resonance imaging for diagnosis and treatment monitoring in multiple myeloma

2020 ◽  
Vol 65 (4) ◽  
pp. 431-443
Author(s):  
N. S. Lutsik ◽  
L. P. Mendeleeva ◽  
M. V. Solovev ◽  
S. M. Kulikov ◽  
Yu. A. Chabaeva ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Whole Body ◽  
Relative Reduction ◽  
Resonance Imaging ◽  
Whole Body Mri ◽  
Adc Values ◽  
Antitumour Response

Introduction. Whole-body diffusion-weighted magnetic resonance imaging (MRI) is an informative method for bone marrow infiltration diagnosis in patients with multiple myeloma (MM) and post-monitoring in autologous haematopoietic stem cell transplantation (auto-HSCT).Aim: to study bone marrow lesions in MM patients using whole-body MRI prior to and after chemotherapy with subsequent auto-HSCT.Materials and methods. Forty patients with MM were included in a prospective study of whole-body MRI before and after high-dose chemotherapy with auto-HSCT. All patients had whole-body MRI prior to and at +100 day of auto-HSCT. Antitumour response was assessed after induction and at +100 day. The number and volume of bone marrow lesions prior to and at +100 day of auto-HSCT were determined, along with apparent diffusion coefficient (ADC) in the lesions.Results. We observed a significant reduction of 29 % in the number of lesions, 40 % — in their volume and 33 % — in ADC. A significant correlation was revealed between relative reduction in the number and volume of foci (r = 0.52, p = 0.0017). A correlation was found between relative reduction in the foci number and ADC (r = 0.47, p = 0.016). Patients with lesions > 7 cm3 in MRI data exhibited a lesser reduction in the foci number and volume and ADC values after auto-HSCT compared to patients with lesions < 7 cm3.Conclusion. Whole-body MRI with diffusion-weighted imaging and subsequent estimation of the number and volume of lesions and their ADC values prior to and after auto-HSCT add power to assessing antitumour response in MM patients with auto-HSCT.

Impact of Whole-Body Magnetic Resonance Imaging on Staging in Patients with Newly Diagnosed Plasma Cell Disease.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5061-5061
Author(s):  
Martin Zoz ◽  
Andreas Baldauf ◽  
Anne Schipp ◽  
Jens Hillengass ◽  
Anthony D. Ho ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Conventional Radiography ◽  
Whole Body ◽  
Newly Diagnosed ◽  
Resonance Imaging ◽  
Cell Disease ◽  
Body Magnetic Resonance Imaging

Abstract INTRODUCTION: MRI has a high sensitivity in determining changes in bone marrow induced by metastatic disease or primary neoplasms of the bone marrow. Whole-Body Magnetic Resonance Imaging (WB-MRI) is a novel imaging technique that displays nearly the complete skeletal system in one exam. We investigated the differences between conventional skeletal survey and WB-MRI and their impact on staging of patients with newly diagnosed plasma cell disease. METHOD AND MATERIALS: In 41 consecutive patients with newly diagnosed MGUS (n=5), Multiple Myeloma (n=34) or AL-Amyloidosis (n=2) conventional radiographs and WB-MRI (coronar T1 tse and T2 tirm sequences and sagittal T2 star sequences, 1,5 T MRI with parallel imaging, Siemens Avanto®) were performed. Radiographs and scans were evaluated for diffuse and focal bone marrow involvement in consent by two experienced radiologists blinded for patient name and study time. Staging was performed including clinical data according to the Salmon/Durie classification system and the Durie/Salmon PLUS classification system with inclusion of WB-MRI. RESULTS: In 24 (59%) patients there were no lesions in conventional radiography or MRI. In 17 (41 %) patients results of MRI and conventional radiography were discrepant. 4 (10%) patients had lesions only in MRI, 3 (7%) only in conventional radiography and 10 (24%) in both techniques but in different localization. In 16 (38%) patients with radiological signs of osteopenia there was no diffuse infiltration in MRI or vice versa. We systematically analysed the consequences of WB-MRI on staging of patients based on the newly proposed staging system Durie/Salmon PLUS. Replacing conventional radiographs by WB-MRI resulted in reclassification of 12 patients. 3 patients were reclassified from MGUS or stage I into stage II or III. 9 patients were downstaged from stage III or II into stage I or MGUS. CONCLUSION: WB-MRI is a valuable technique for the initial work-up of patients with Multiple Myeloma. In comparison with conventional skeletal survey there are often differing results with impact on clinical staging and influence on therapy decision. WB-MRI can give additional information in patients with unclear staging situation before onset of therapy. Further evaluation of WB-MRI within prospective studies is warranted in particular with respect to prognostic impact regarding overall prognosis as well as regarding local complications. Until then WB-MRI should be used complementary to conventional radiography or CT-techniques that provide accurate imaging of the bone.

Prognostic Significance of Focal Lesions in Whole-Body Magnetic Resonance Imaging in Patients With Asymptomatic Multiple Myeloma

2010 ◽  
Vol 28 (9) ◽  
pp. 1606-1610 ◽  
Author(s):  
Jens Hillengass ◽  
Kerstin Fechtner ◽  
Marc-André Weber ◽  
Tobias Bäuerle ◽  
Sofia Ayyaz ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Prognostic Factors ◽  
Magnetic Resonance ◽  
Prognostic Significance ◽  
Whole Body ◽  
Resonance Imaging ◽  
Focal Lesions ◽  
Body Magnetic Resonance Imaging

Purpose With whole-body magnetic resonance imaging (wb-MRI), almost the whole bone marrow compartment can be examined in patients with monoclonal plasma cell disease. Focal lesions (FLs) detected by spinal MRI have been of prognostic significance in symptomatic multiple myeloma (sMM). In this study, we investigated the prognostic significance of FLs in wb-MRI in patients with asymptomatic multiple myeloma (aMM). Patients and Methods Wb-MRI was performed in 149 patients with aMM. The prognostic significance of the presence and absence, as well as the number, of FLs for progression into sMM was analyzed. Results FLs were present in 28% of patients. The presence per se of FLs and a number of greater than one FL were the strongest adverse prognostic factors for progression into sMM (P < .001) in multivariate analysis. A diffuse infiltration pattern in MRI, a monoclonal protein of 40 g/L or greater, and a plasma cell infiltration in bone marrow of 20% or greater were other adverse prognostic factors for progression-free survival in univariate analysis. Conclusion We recommend use of wb-MRI for risk stratification of patients with asymptomatic multiple myeloma.

Diagnostic Effectiveness of whole Body Diffusion- Weighted Magnetic Resonance Imaging in Focal and Diffuse Bone Marrow Involvement in Patients with Lymphoma

2017 ◽  
pp. 66-81 ◽  
Author(s):  
S. A. Kharuzhyk ◽  
E. A. Zhavrid ◽  
N. U. Sachivko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Pulse Sequences ◽  
Whole Body ◽  
Resonance Imaging ◽  
Trephine Biopsy ◽  
Whole Body Mri ◽  
Iliac Wing ◽  
Diffusion Weighted

Objective:to compare diagnostic effectiveness of whole body  diffusion-weighted imaging (DWI), other magnetic resonance  imaging (MRI) pulse sequences and iliac wing trephine biopsy in the  diagnosis of focal and diffuse bone marrow (BM) involvement in patients with lymphoma.Materials and methods.Prospective study included 130 patients  with lymphoma who underwent whole-body MRI-DWI and iliac wing  trephine biopsy before treatment (64 (49,2%) men, 66 (50,8%)  women, middle age 43,3 ± 16,3 years, interval of 18–79 years).  Hodgkin's lymphoma (HL) was at 57 (44%) patients, non-Hodgkin  lymphomas (NHL) – at 73 (56%). Diagnostic effectiveness of T1- weighted images (T1-WI), STIR, DWI and FIESTA was analyzed. BM  apparent diffusion coefficient (ADC) values were measured.Results.BM involvement was found in 42 patients, including 9 with  HL and 33 with NHL. In HL, BM involvement was only focal. Diffuse  involvement occurred more often (64%) in the NHL as compared to  focal one. In focal involvement, all pulse sequences showed high  diagnostic sensitivity (90–100%), BM biopsy sensitivity was 33%  only. The proposed new criterion for the diagnosis of diffuse BM involvement in NHL – diffuse signal increase of the spine on DWI  above renal parenchyma – has the highest sensitivity (90%) compared to T1-WI and STIR (67%) and FIESTA (71%) (p < 0.05).  In NHL, the ADC value ≤0.575 • 10−3 mm2/s discrimi nates cases  of diffuse involvement and absence of BM involvement with a  sensitivity of 86% and a specificity of 68% (p < 0.0001). In HL, the  diffuse BM signal increase on DWI is not indicative of involvement.Conclusion.All pulse sequences showed high effectiveness in the  diagnosis of focal BM involvement in patients with lymphoma, iliac  wing biopsy effectiveness was low. The proposed new DWI criterion  for diagnosing diffuse BM involvement in NHL is the most sensitive  one. A new algorithm based on whole body MRI-DWI for the  diagnosis of BM involvement allows to reduce the need for BM biopsy without reducing the diagnostic effectiveness.

scholarly journals Prognostic significance of magnetic resonance imaging of bone marrow in previously untreated patients with multiple myeloma

2005 ◽  
Vol 16 (11) ◽  
pp. 1824-1828 ◽  
Author(s):  
L.A. Moulopoulos ◽  
D. Gika ◽  
A. Anagnostopoulos ◽  
K. Delasalle ◽  
D. Weber ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Prognostic Significance ◽  
Resonance Imaging

scholarly journals Role of Magnetic Resonance Imaging in the Management of Patients With Multiple Myeloma: A Consensus Statement

2015 ◽  
Vol 33 (6) ◽  
pp. 657-664 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Jens Hillengass ◽  
Saad Usmani ◽  
Elena Zamagni ◽  
Suzanne Lentzsch ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Myeloma ◽  
Magnetic Resonance ◽  
Bone Destruction ◽  
Whole Body ◽  
Focal Lesion ◽  
Resonance Imaging ◽  
Pelvic Mri ◽  
Symptomatic Disease ◽  
Osteoporotic Vertebral Fractures

Purpose The aim of International Myeloma Working Group was to develop practical recommendations for the use of magnetic resonance imaging (MRI) in multiple myeloma (MM). Methods An interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations for the value of MRI based on data published through March 2014. Recommendations MRI has high sensitivity for the early detection of marrow infiltration by myeloma cells compared with other radiographic methods. Thus, MRI detects bone involvement in patients with myeloma much earlier than the myeloma-related bone destruction, with no radiation exposure. It is the gold standard for the imaging of axial skeleton, for the evaluation of painful lesions, and for distinguishing benign versus malignant osteoporotic vertebral fractures. MRI has the ability to detect spinal cord or nerve compression and presence of soft tissue masses, and it is recommended for the workup of solitary bone plasmacytoma. Regarding smoldering or asymptomatic myeloma, all patients should undergo whole-body MRI (WB-MRI; or spine and pelvic MRI if WB-MRI is not available), and if they have > one focal lesion of a diameter > 5 mm, they should be considered to have symptomatic disease that requires therapy. In cases of equivocal small lesions, a second MRI should be performed after 3 to 6 months, and if there is progression on MRI, the patient should be treated as having symptomatic myeloma. MRI at diagnosis of symptomatic patients and after treatment (mainly after autologous stem-cell transplantation) provides prognostic information; however, to date, this does not change treatment selection.

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