Comparison of MRI Features of Fat Fraction and ADC for Early                     Treatment Response Assessment in Participants with Multiple                     Myeloma

Koutoulidis, Vassilis; Terpos, Evangelos; Papanikolaou, Nikolaos; Fontara, Sophia; Seimenis, Ioannis; Gavriatopoulou, Maria; Ntanasis‐Stathopoulos, Ioannis; Bourgioti, Charis; Santinha, João; Moreira, José Maria; Kastritis, Efstathios; Dimopoulos, Meletios Α.; Moulopoulos, Lia A.

doi:10.1148/radiol.211388

Cited by 21 publications

(23 citation statements)

References 26 publications

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“…We did not divide the infiltration pattern according to MRI performance and we believe that this “agnostic” approach provides a more reliable marrow sample for evaluation of BM infiltration. 25 …”

Section: Discussionmentioning

confidence: 99%

Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma

Xiong,

Hong,

Fan

et al. 2024

Radiology and Oncology

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Background The aim of the study was to evaluate whether virtual calcium subtraction (VNCa) image extracted from dual-layer spectral CT could estimate bone marrow (BM) infiltration with MRI as the reference standard and characterize tumor burden in patients with multiple myeloma (MM). Patients and methods Forty-seven patients with newly diagnosed MM were retrospectively enrolled. They had undergone whole-body low-dose dual-layer spectral CT (DLCT) and whole-body MRI within one week. VNCa images with calcium-suppressed (CaSupp) indices ranging from 25 to 95 at an interval of 10 and apparent diffusion coefficient (ADC) maps were quantitatively analyzed on vertebral bodies L1−L5 at the central slice of images. The optimal combination was selected by correlation analysis between CT numbers and ADC values. Then, it was used to characterize tumor burden by correlation analysis and receiver operating characteristic (ROC) curves analysis, including plasma cell infiltration rate (PCIR), high serum-free light chains (SFLC) ratio and the high-risk cytogenetic (HRC) status. Results The most significant quantitative correlation between CT numbers of VNCa images and ADC values could be found at CaSupp index 85 for averaged L1−L5 (r = 0.612, p < 0.001). It allowed quantitative evaluation of PCIR (r = 0.835, p < 0.001). It could also anticipate high SFLC ratio and the HRC status with area under the curve (AUC) of 0.876 and 0.760, respectively. Conclusions The VNCa measurements of averaged L1−L5 showed the highest correlation with ADC at CaSupp index 85. It could therefore be used as additional imaging biomarker for non-invasive assessment of tumor burden if ADC is not feasible.

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Section: Discussionmentioning

confidence: 99%

Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma

Xiong,

Hong,

Fan

et al. 2024

Radiology and Oncology

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“…The use of the Dixon also allows researchers to evaluate the degree of adipose re-population of the responding lesions after treatment, therefore adding the ability to discriminate responding lesions compared to lesions resistant to therapy and reducing the false-positive cases in DWI [ 38 ]. Koutoulidis [ 43 ] studied histogram metrics from ADC and relative fat fraction maps from MRI examinations of 23 patients performed before treatment and after the first treatment cycle. Fat fraction histogram metrics had a higher performance than ADC histogram metrics upon MRI examination for predicting very early therapy response assessment.…”

Section: Wbmrimentioning

confidence: 99%

Imaging of Multiple Myeloma: Present and Future

Rodríguez-Laval,

Lumbreras-Fernández,

Aguado-Bueno

et al. 2024

JCM

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Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start treatment. Low-dose whole-body computed tomography (CT) is the modality of choice for the initial assessment, and dual-energy CT is a developing technique with the potential for detecting non-lytic marrow infiltration and evaluating the response to treatment. Magnetic resonance imaging (MRI) is more sensitive and specific than 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for the detection of small focal lesions and diffuse marrow infiltration. However, FDG-PET/CT is recommended as the modality of choice for follow-up. Recently, diffusion-weighted MRI has become a new technique for the quantitative assessment of disease burden and therapy response. Although not widespread, we address current proposals for structured reporting to promote standardization and diminish variations. This review provides an up-to-date overview of MM imaging, indications, advantages, limitations, and recommended reporting of each technique. We also cover the main differential diagnosis and pitfalls and discuss the ongoing controversies and future directions, such as PET-MRI and artificial intelligence.

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“…This methodology includes the production of 4 distinct types of images: in-phase (IP), out-of-phase (OP), water-only (WO), and fat-only (FO). [47][48][49] Furthermore, research has demonstrated that T2 Dixon fat-only Dixon images exhibit greater efficacy in detecting lesions in multiple myeloma than in-phase images alone. [50] (4) PET: The International Myeloma Work Group suggests that PET/CT be employed to evaluate the distribution and activity level of MM as well as to analyze the physiological, biochemical, pathological, metabolic, and other biological features of tumor cells in tissues.…”

Section: Imaging Characteristicsmentioning

confidence: 99%

“…This methodology includes the production of 4 distinct types of images: in-phase (IP), out-of-phase (OP), water-only (WO), and fat-only (FO). [47–49] Furthermore, research has demonstrated that T2 Dixon fat-only Dixon images exhibit greater efficacy in detecting lesions in multiple myeloma than in-phase images alone. [50]…”

Section: Imaging Characteristicsmentioning

confidence: 99%

New diagnostic strategy for multiple myeloma: A review

Xu,

2023

Medicine

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Multiple myeloma (MM) is the second most prevalent hematological malignancy and is distinguished by the aberrant proliferation of monoclonal plasma cells inside the bone marrow and production of M-protein. This condition frequently results in bone deterioration, acute kidney damage, anemia, and hypercalcemia. However, the clinical manifestations and accompanying symptoms of MM vary and may change as the condition evolves. Therefore, diagnosis of MM is difficult. At present, the confirmation of MM diagnosis necessitates the use of bone marrow biopsy, a procedure that is both invasive and challenging for assessing dynamic alterations in the disease. The integration of laboratory testing technologies with imaging technology has the potential to enhance the diagnostic effectiveness and provide a thorough evaluation of disease progression and prognosis in patients with MM. All the examination methods have advantages and disadvantages. Therefore, diagnosis is determined by the application of clinical characteristics, serological tests, and imaging investigations.

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Comparison of MRI Features of Fat Fraction and ADC for Early Treatment Response Assessment in Participants with Multiple Myeloma

Cited by 21 publications

References 26 publications

Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma

Quantitative assessment of bone marrow infiltration and characterization of tumor burden using dual-layer spectral CT in patients with multiple myeloma

Imaging of Multiple Myeloma: Present and Future

New diagnostic strategy for multiple myeloma: A review

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