Multiple myeloma: MR patterns of response to treatment.

Moulopoulos, Lia A.; Dimopoulos, MA; Alexanian, Raymond; Leeds, N E; Libshitz, HI

doi:10.1148/radiology.193.2.7972760

Cited by 146 publications

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“…This suggests that the proposed BM-MRI technique and the scoring system can be used as a valid tool for patients with active MM despite minor variations. In contrast to previously used terms such as focal, multiple focal, patchy, diffuse etc, [9][10][11][12]16 the proposed system determines BM-MRI stages based on the percentage involvement and therefore potentially reduces interobserver and interpopulation variability during interpretation of the BM-MRI. This scoring system likely will add to the currently used DS and ISS staging systems by assessing bone marrow infiltration in patients with MM more accurately, thus aiding better clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports on BM-MRI evaluation have used a subjective classification of bone marrow infiltration with ''focal,'' ''patchy/variegated,'' and ''diffuse'' patterns. [9][10][11][12] To our knowledge, a more objective BM-MRI examination and staging technique has not been investigated formally in patients with MM, particularly its correlation with other standard clinical parameters of the disease and its correlation with overall survival. In the current study, we prospectively evaluated the role of BM-MRI in patients with MM to objectively quantify the extent of bone marrow infiltration and correlated this with standard clinical and prognostic markers of disease.…”

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confidence: 99%

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Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

Ailawadhi

Abdelhalim

Derby

et al. 2009

Cancer

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The final properties of the composites materials are strongly dependent on the residual aspect ratio, orientation, and distribution of the fibers, which are determined by the processing conditions. Present work is a systematic study of the influence of natural fiber concentration on its damage during all the steps involved in the composite compounding. The system under study is cellulose fiber‐reinforced polypropylene. The fiber geometrical parameters—length, diameter, and aspect ratio—are measured, and their statistical distributions are assessed for different concentrations. It is found that the higher the fiber concentration, the lower the fiber damage. These results evidence a difference in behavior between the damage of flexible natural fiber and rigid ones. The results are analyzed in terms of fiber concentration regimes, fiber–fiber interaction, flexibility, and entanglements. Two competitive mechanisms of the fiber interaction are proposed for explaining the fiber damage behavior during the flow of the flexible natural fiber suspensions. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 103: 2501–2506, 2007

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

Ailawadhi

Abdelhalim

Derby

et al. 2009

Cancer

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“…In multiple myelomas, an increased marrow signal is usually observed on post-treatment T1-weighted images due to replacement of tumour cells by fat cells. Response patterns associate normal aspects of bone marrow or persistent marrow abnormality, without contrast enhancement or only a peripheral rim enhancement [19,20] . Local radiation therapy induces a decrease in lesion size and a central necrosis.…”

Section: Lymphomas and Leukaemiasmentioning

confidence: 94%

Improving the interpretation of bone marrow imaging in cancer patients

et al. 2006

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Magnetic resonance imaging (MRI) is the best technique for bone marrow imaging. The MRI signal of bone marrow depends on the quantity of fat it contains and on its cellularity. Evaluation of marrow of patients treated for cancer is complicated by age and osseous site related changes in the distribution of normal haematopoietic (red) and fatty (yellow) marrow and by the changes induced by treatments: decrease in pathological cellularity, increase in fat proportion, conversion of red marrow to fatty marrow or, conversely, reconversion of fatty marrow in normal haematopoietic red marrow. The treatments used in oncology modify pathological marrow but also normal marrow and may sometimes lead to complications. These modifications may be focal or diffuse, homogeneous or patchy and symmetrical or asymmetric. The knowledge of bone marrow physiological status and post-therapeutic patterns is important for the interpretation of marrow disorders and effects of therapy and to avoid false-positive diagnosis of marrow metastases and tumour progression. The aim of this paper is to recall the MRI patterns of normal bone marrow and normal variations and to show the effects of treatments on bone tissue and normal bone marrow and treatment-related modifications on pathological marrow.

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“…8,[12][13][14] MRI has a sensitivity of 68%, a specificity of 83%, a positive predictive value of 88% and is superior to PET-CT. 15 Furthermore, the development of fast sequences allows MRI to be performed as a whole-body protocol (wb-MRI), replacing the use of spinal MRI alone. 16 Focal lesions and diffuse tumor cell infiltration detected by wb-MRI have been demonstrated to be of prognostic significance for predicting progression free and overall survival in monoclonal plasma cell diseases.…”

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confidence: 99%

Appearance of monoclonal plasma cell diseases in whole‐body magnetic resonance imaging and correlation with parameters of disease activity

Kloth

Hillengaß

Listl

et al. 2014

Intl Journal of Cancer

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The aim of our study was to assess in which way different infiltration patterns of monoclonal plasma cell diseases in wholebody (wb) magnetic resonance imaging (MRI) are associated with clinical stages, plasma cell content in bone marrow samples and established serum markers of disease activity. Institutional review board approval was obtained. We performed wb-MRI in 547 consecutive, unselected and untreated patients with monoclonal gammopathy of undetermined significance (MGUS, n 5 138), smoldering myeloma (SMM, n 5 157) and multiple myeloma (MM, n 5 252) on two 1.5 T MRI-scanners with body array coils. The studies were evaluated in consensus by two experienced radiologists blinded to the diagnosis. We observed focal lesions in 23.9% (MGUS), 34.4% (SMM) and 81.3% (MM), respectively. A diffuse infiltration pattern was detected in 38.4%, 45.9% and 71%, respectively. The differences between all infiltration patterns were significant (p < 0.0001). The presence of focal lesions and the presence of a diffuse bone marrow infiltration was associated with an increased plasma cell percentage in bone marrow samples (median 22% vs. 14%, 26% vs. 10%, both p < 0.0001) and monoclonal protein concentration (median 18 g/dl vs. 13 g/dl, p 5 0.003, 20 g/dl vs. 11 g/dl, p < 0.0001). Further categorization of the diffuse infiltration patterns in wb-MRI into "salt-and-pepper," moderate and severe identified significant associations with M-protein (median g/dl for S1P/moderate/severe 23/18/25, p 5 0.04), plasma cell percentage in the bone marrow (median 25%/24%/40%, p 5 0.02), and age (median years 67/60/57, p < 0.0001). Bone marrow infiltration in wb-MRI is significantly different between the various stages of plasma cell disease and correlates well with established markers of disease activity.Monoclonal plasma cell diseases like multiple myeloma (MM), monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM) are a group of hematologic premalignant or malignant disorders associated with monoclonal proliferation of plasma cells mainly in the bone marrow.1,2 Although MGUS, being the most common disorder of plasma cells and occurring in 2% of persons older than 50 years, has an overall annual risk of progression of only 1% per year, the rate of transformation of SMM to MM or systemic amyloidosis (AL) has been shown to be 10% per year in the first 5 years. [3][4][5][6] In the aforementioned monoclonal plasma cell disorders, the bone marrow involvement may be present in different patterns: diffuse bone marrow infiltration and focal lesions. Diffuse bone marrow infiltration is characterized by malignant plasma cells, mixed up with normal bone marrow cells, still preserving the cancellous bone structure. Focal lesions are circumscribed solid foci of plasma cells with the potential of destruction of the cancellous and cortical bone.To image these changes, plain radiographs (PRs), computed tomography (CT) and magnetic resonance imaging (MRI) are currently in routine use. 7 Although PR has been an integral part of...

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Multiple myeloma: MR patterns of response to treatment.

Abstract: Recognition of spinal MR patterns of response to treatment supported the occurrence of remission in patients with multiple myeloma. MR findings may help clarify response to therapy in patients with equivocal clinical changes or nonsecretory myeloma.

Cited by 146 publications

References 0 publications

Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma

Improving the interpretation of bone marrow imaging in cancer patients

Appearance of monoclonal plasma cell diseases in whole‐body magnetic resonance imaging and correlation with parameters of disease activity

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