Imaging findings and clinical features of patients with multiple myeloma with the prognostic effect of bone marrow focal and diffuse infiltration patterns on spine MRI.

Aim: Aim of this study was to evaluate the prognostic effect of the magnetic resonance imaging (MRI) infiltration type as diffuse or focal patterns on spine magnetic resonance imaging (MRI), as well as other imaging and clinical features of patients with multiple myeloma.
Methods: A retrospective analysis of 35 patients with multiple myeloma was performed in this study. Patients were mean of 56.5 ± 12.4 year old, male/female ratio=1.3. Patients were at stage 2 and one at stage 3. Skeletal surveys were obtained in all patients, additionally bone scintigraphy (N.=25), CT (N.=22), and spine MRI (N.=16) were conducted. On imaging, lesion number, size and distribution and characteristics were assessed. On MRI, bone marrow involvements were assessed as focal and diffuse patterns (mild, moderate, and severe). All patients were followed-up with MRI for a median of 8.5 months (range, 1-105). Statistical analysis for bone marrow infiltration on MRI was performed using Kaplan-Meier survival test.
Results: Patients with diffuse infiltration pattern on MRI survived as median 13.0 months (range, 1-105), whereas cases with only focal pattern survived as median 3.5 months (range, 1-27). There was no difference between these groups (P=0.071). The disease-free survivals were not different, either (P=0.118). Scintigraphy, CT, and MRI detected more lesions in flat bones except for cranium where craniography was successful.
Conclusion: It was not possible to find any further effect of the diffuse MRI infiltration type beyond focal infiltration on overall and disease-free survivals. Among typical findings of the radiography, spherical, punched-out lesions were seen, but lesion uniformity was not seen.