A Comparison of Different Staging Systems for Multiple Myeloma: Can the MRI Pattern Play a Prognostic Role?

Filonzi, Giacomo; Mancuso, Katia; Zamagni, Elena; Nanni, Cristina; Spinnato, Paolo; Cavo, Michèle; Fanti, Stefano; Salizzoni, Eugenio; Bazzocchi, Alberto

doi:10.2214/ajr.16.17219

Cited by 32 publications

(15 citation statements)

References 23 publications

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“…It is believed that DS Plus is a reliable method for both staging and prognostic classification. The prognostic significance of DS Plus has been reported in one recent study using MRI of the spine and pelvis in 85 patients [ 27 ]. However, Fechtner et al have reported that the DS Plus is not better than the DSS for the prediction of OS [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of¹⁸F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

Deng

Zhang

Zhou

et al. 2018

Contrast Media & Molecular Imaging

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We aimed at comparing the Durie–Salmon Plus (DS Plus) staging system based on Italian Myeloma criteria for PET USe (IMPeTUs) with other two staging systems in predicting prognosis of patients with all stages of newly diagnosed multiple myeloma (MM). A total of 33 MM patients were enrolled in this retrospective study. The variation between the DS Plus classification and Durie–Salmon staging system (DSS) or Revised International Staging System (RISS) classification was assessed. When staged by the DSS, patients in stage I and stage II did not reach the median overall survival (OS), and the median OS was 33 months for stage III (p=0.3621). When staged by the DS Plus, patients in stage I did not reach the median OS of stage I, and the median OS for stages II and III was 38 and nine months, respectively (p=0.0064). When staged by the RISS, patients in stage I did not reach the median OS, and the median OS was 33 and 16 months for stage II and stage III, respectively (p=0.0319). The concordances between two staging systems were 0.07 (DS Plus versus DSS) and 0.37 (DS Plus versus RISS), respectively. Multivariate analysis revealed that DS Plus stage III (HR: 11.539, p=0.021) and the Deauville score of bone marrow ≥4 (HR: 3.487, p=0.031) were independent prognostic factors associated with OS. Both the DS Plus based on IMPeTUs and RISS possessed a better potential in characterizing and stratifying MM patients compared with the DSS. Moreover, DS Plus stage III and the Deauville score of bone marrow ≥4 were reliable prognostic factors in newly diagnosed MM patients.

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Section: Discussionmentioning

confidence: 99%

The Role of¹⁸F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

Deng

Zhang

Zhou

et al. 2018

Contrast Media & Molecular Imaging

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“…[46][47][48][60][61][62][63] This is probably one of the reasons for discrepant results in the literature as to which MRI pattern confers a worse prognosis in patients with newly diagnosed MM. [64][65][66] Moreover, the diffuse pattern (as opposed to the focal pattern) has not been incorporated in the updated criteria for the diagnosis of symptomatic myeloma. 43 WBDWI has been shown to be more sensitive than fluorodeoxyglucose PET-CT in detecting diffuse disease, by visually assessing the inverted grayscale maximum intensity projection images with b-value 800-900 s mm -2 .…”

Section: Whole Body Mri and Whole Body Diffusionweighted Imagingmentioning

confidence: 99%

Functional and molecular MRI of the bone marrow in multiple myeloma

Koutoulidis

Papanikolaou

Moulopoulos

2018

BJR

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MRI plays an important role in the management of patients with plasma cell neoplasms and has been recognized as a biomarker of malignancy in the novel criteria for the diagnosis of multiple myeloma. Functional and molecular MRI techniques such as diffusion-weighted imaging (spinal or whole body), intravoxel incoherent motion, and dynamic contrast enhanced MRI, provide additional information related to tumor cellularity and angiogenesis, which may have prognostic implications for patients with smoldering and symptomatic myeloma. These non-invasive functional techniques are also being evaluated as imaging biomarkers for response assessment in myeloma patients. The purpose of this article is to provide a comprehensive critical review on the current use and potential future applications of these advanced MRI techniques in multiple myeloma. In addition, we will address the technologies involved and describe the qualitative and quantitative characteristics of normal bone marrow with these techniques.

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“…The updated Durie-Salmon PLUS system for MM staging, which was found to be determinative of treatment response and survival outcome incorporates lesion quantification from whole body imaging survey in addition to serum biomarkers (11). Historically the Mirels score on conventional radiography (CR) predicted risk of fracture and guided to select between radiotherapy or preventive osteosynthesis as an intervention in patients with MM (12).…”

Section: Transmission Imaging Modalities For Multiple Myeloma Work-upmentioning

confidence: 99%

Revisited clinical implication of 99mTc-Sestamibi scan for staging Multiple Myeloma as an affordable alternative modality: A Case report

Naznin

Sarker

Rahman

et al. 2021

Bangladesh J. Nuclear Med.

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Background: Staging of multiple myeloma (MM) requires quantification of lesions and serum biomarkers. Sestamibi (MIBI) scan can detect medullary and extra-medullary lesions whereas pathological fracture of MM when associated with osteoblastic activity which can be imaged by methyl diphosphonate (MDP). Patients and methods: This case report is of a biopsy proven case of MM with serum biomarkers inconclusive for staging. With evidence of multiple pathological rib fractures on conventional radiography, the patient was sent for MDP scan as she was unable to afford any other modality for whole body survey. A complimentary MIBI scan was therefore done. Results: MDP scan revealed multiple osteoblastic lesions in spine and ribs. The MIBI scan was conclusive for stage II active disease. Conclusions: MIBI scan added to diagnostic information and aided an inexpensive staging. MIBI scan can be an affordable work-up tool for MM. Bangladesh J. Nuclear Med. 22(2): 150-154, Jul 2019

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A Comparison of Different Staging Systems for Multiple Myeloma: Can the MRI Pattern Play a Prognostic Role?

Cited by 32 publications

References 23 publications

The Role of¹⁸F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

The Role of¹⁸F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

Functional and molecular MRI of the bone marrow in multiple myeloma

Revisited clinical implication of 99mTc-Sestamibi scan for staging Multiple Myeloma as an affordable alternative modality: A Case report

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A Comparison of Different Staging Systems for Multiple Myeloma: Can the MRI Pattern Play a Prognostic Role?

Cited by 32 publications

References 23 publications

The Role of18F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

The Role of18F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

Functional and molecular MRI of the bone marrow in multiple myeloma

Revisited clinical implication of 99mTc-Sestamibi scan for staging Multiple Myeloma as an affordable alternative modality: A Case report

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The Role of¹⁸F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems

The Role of¹⁸F-FDG PET/CT in Multiple Myeloma Staging according to IMPeTUs: Comparison of the Durie–Salmon Plus and Other Staging Systems