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Whole body magnetic resonance imaging in newly diagnosed multiple myeloma: early changes in lesional signal fat fraction predict disease response.

Authors :
Latifoltojar A
Hall-Craggs M
Rabin N
Popat R
Bainbridge A
Dikaios N
Sokolska M
Rismani A
D'Sa S
Punwani S
Yong K
Source :
British journal of haematology [Br J Haematol] 2017 Jan; Vol. 176 (2), pp. 222-233. Date of Electronic Publication: 2016 Oct 21.
Publication Year :
2017

Abstract

Cross-sectional imaging techniques are being increasingly used for disease evaluation in patients with multiple myeloma. Whole body magnetic resonance imaging (WB-MRI) scanning is superior to plain radiography in baseline assessment of patients but changes following treatment have not been systematically explored. We carried out paired WB-MRI scans in 21 newly diagnosed patients prior to, and 8-weeks after, starting chemotherapy, and analysed stringently selected focal lesions (FLs) for parametric changes. A total of 323 FLs were evaluated, median 20 per patient. At 8 weeks, there was a reduction in estimated tumour volume (eTV), and an increase in signal fat fraction (sFF) and apparent diffusion coefficient (ADC) in the group as a whole (P < 0·001). Patients who achieved complete/very good partial response (CR/VGPR) to induction had a significantly greater increase in sFF compared to those achieving ≤ partial response (PR; P = 0·001). When analysed on a per-patient basis, all patients achieving CR/VGPR had a significant sFF increase in their FL's, in contrast to patients achieving ≤PR. sFF changes in patients reaching maximal response within 100 days (fast responders) were greater compared to slow responders (P = 0·001). Receiver Operator Characteristic analysis indicated that sFF changes at 8 weeks were the best biomarker (area under the Curve 0·95) for an inferior response (≤PR). We conclude that early lesional sFF changes may provide important information on depth of response, and are worthy of further prospective study.<br /> (© 2016 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1365-2141
Volume :
176
Issue :
2
Database :
MEDLINE
Journal :
British journal of haematology
Publication Type :
Academic Journal
Accession number :
27766627
Full Text :
https://doi.org/10.1111/bjh.14401