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Association between magnetic resonance imaging patterns and baseline disease features in multiple myeloma: analyzing surrogates of tumour mass and biology

OBJECTIVE: To assess associations between bone marrow infiltration patterns and localization in magnetic resonance imaging (MRI) and baseline clinical/prognostic parameters in multiple myeloma (MM). METHODS: We compared baseline MM parameters, MRI patterns and localization of focal lesions to the mi...

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Main Authors: Mai, Elias K. (Author) , Kloth, Jost (Author) , Merz, Maximilian (Author) , Shah, Sofia (Author) , Hillengaß, Michaela (Author) , Wagner, Barbara (Author) , Hose, Dirk (Author) , Raab, Marc-Steffen (Author) , Jauch, Anna (Author) , Goldschmidt, Hartmut (Author) , Weber, Marc-André (Author) , Hillengaß, Jens (Author)
Format: Article (Journal)
Language:English
Published: 15 January 2016
In: European radiology
Year: 2016, Volume: 26, Issue: 11, Pages: 3939-3948
ISSN:1432-1084
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Author Notes:Elias K. Mai, Thomas Hielscher, Jost K. Kloth, Maximilian Merz, Sofia Shah, Michaela Hillengass, Barbara Wagner, Dirk Hose, M. S. Raab, Anna Jauch, Stefan Delorme, Hartmut Goldschmidt, Marc-André Weber, Jens Hillengass
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Summary:OBJECTIVE: To assess associations between bone marrow infiltration patterns and localization in magnetic resonance imaging (MRI) and baseline clinical/prognostic parameters in multiple myeloma (MM). METHODS: We compared baseline MM parameters, MRI patterns and localization of focal lesions to the mineralized bone in 206 newly diagnosed MM patients. RESULTS: A high tumour mass (represented by International Staging System stage III) was significantly associated with severe diffuse infiltration (p = 0.015) and a higher number of focal lesions (p = 0.006). Elevated creatinine (p = 0.003), anaemia (p < 0.001) and high LDH (p = 0.001) correlated with severe diffuse infiltration. A salt and pepper diffuse pattern had a favourable prognosis. A higher degree of destruction of mineralized bone (assessed by X-ray or computed tomography) was associated with an increasing number of focal lesions on MRI (p < 0.001). Adverse cytogenetics (del17p/gain1q21/t(4;14)) were associated with diffuse infiltration (p = 0.008). The presence of intraosseous focal lesions exceeding the mineralized bone had a borderline significant impact on prognosis. CONCLUSIONS: Diffuse bone marrow infiltration on MRI correlates with adverse cytogenetics, lowered haemoglobin values and high tumour burden in newly diagnosed MM whereas an increasing number of focal lesions correlates with a higher degree of bone destruction. Focal lesions exceeding the cortical bone did not adversely affect the prognosis. KEY POINTS: • Diffuse MRI correlates with adverse cytogenetics, lowered haemoglobin and high tumour burden. • Higher numbers of MRI focal lesions correlate with increasing degree of bone destruction. • Focal lesions exceeding the cortical bone borderline significantly influence survival. • Moderate/severe diffuse infiltration and more than 23 focal lesions adversely affect survival.
Item Description:Gesehen am 11.12.2017
Physical Description:Online Resource
ISSN:1432-1084

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