Current Concepts in MRI of Focal and Diffuse Malignancy of Bone Marrow

Howe, Benjamin M.; Johnson, Geoffrey B.; Wenger, Doris E.

doi:10.1055/s-0033-1343069

Cited by 24 publications

(4 citation statements)

References 49 publications

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“…Nonetheless, the marrow compartment remains an important reservoir for disease relapse since marrow MRD early after consolidation with immunotherapy was the strongest predictor of PFS and OS. 89 …”

Section: Lessons Learned From Clinical Trials Of Anti-gd2 Antibodiesmentioning

confidence: 99%

GD2-Targeted Immunotherapy and Radioimmunotherapy

Dobrenkov

Cheung

2014

Seminars in Oncology

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Ganglioside GD2 is a tumor-associated surface antigen found in a broad spectrum of human cancers and stem cells. They include pediatric embryonal tumors (neuroblastoma, retinoblastoma, brain tumors, osteosarcoma, Ewing’s sarcoma, rhabdomyosarcoma), as well as adult cancers (small cell lung cancer, melanoma, soft tissue sarcomas). Because of its restricted normal tissue distribution, GD2 has been proven safe for antibody targeting. Anti-GD2 antibody is now incorporated into the standard of care for the treatment of high risk metastatic neuroblastoma. Building on this experience, novel combinations of antibody, cytokines, cells and genetically engineered products all directed at GD2 are rapidly moving into the clinic. In the review, past and present immunotherapy trials directed at GD2 will be summarized, highlighting the lessons learned and the future directions.

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Section: Lessons Learned From Clinical Trials Of Anti-gd2 Antibodiesmentioning

confidence: 99%

GD2-Targeted Immunotherapy and Radioimmunotherapy

Dobrenkov

Cheung

2014

Seminars in Oncology

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“…High 18 F-FDG uptake of the brain and limited spatial resolution of PET images taken together create artifacts that hamper the inclusion of skull in IBI calculation, and focal lesions in this area must be analyzed independently. Although skull involvement is relatively common in MM, the bone sites most frequently and extensively affected by the disease are the spine, pelvis, sternum and proximal metaphyses of long bones, because adult bone marrow is predominantly confined in these sites 39,40 . In our sample of 59 patients, only three (5%) had cranial involvement, demonstrated by 18 F-FDG-PET/CT, all with relatively small lesions compared to those of the spine and pelvis.…”

Section: Discussionmentioning

confidence: 99%

Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma

Takahashi

Mosci

Souza

et al. 2019

Sci Rep

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Many efforts have been made to standardize the interpretation of 18 f-fDG pet/ct in multiple myeloma (MM) with qualitative visual analysis or with quantitative metabolic parameters using various methods for lesion segmentation of PET images. The aim of this study was to propose a quantitative method for bone and bone marrow evaluation of 18 F-FDG PET/CT considering the extent and intensity of bone 18 F-FDG uptake: Intensity of Bone Involvement (IBI). Whole body 18 F-FDG PET/CT of 59 consecutive MM patients were evaluated. Compact bone tissue was segmented in PET images using a global threshold for HU of the registered CT image. A whole skeleton mask was created and the percentage of its volume with 18 F-FDG uptake above hepatic uptake was calculated (Percentage of Bone Involvement -PBI). IBI was defined by multiplying PBI by mean SUV above hepatic uptake. IBI was compared with visual analysis performed by two experienced nuclear medicine physicians. IBI calculation was feasible in all images (range:0.00-1.35). Visual analysis categorized PET exams into three groups (negative/ mild, moderate and marked bone involvement), that had different ranges of IBI (multi comparison analysis, p < 0.0001). There was an inverse correlation between the patients' hemoglobin values and IBI (r = −0.248;p = 0.02). IBI score is an objective measure of bone and bone marrow involvement in MM, allowing the categorization of patients in different degrees of aggressiveness of the bone disease. The next step is to validate IBI in a larger group of patients, before and after treatment and in a multicentre setting.Lytic bone lesions are reported in approximately 80% of myeloma multiple (MM) patients 1,2 . Early and precise evaluation of bone involvement is crucial for staging and correct disease management.Hybrid image of positron emission tomography with 18 F-fluordeoxyglucose and computed tomography ( 18 F-FDG PET/CT) is one of the main methods for the evaluation of MM patients. It allows whole-body images, intra and extramedullary lesion detection, distinction between active lesions and scar or necrotic tissue and has been more sensitive than MRI in treatment assessment 3-5 .Many efforts have been attempted to standardize the interpretation of 18 F-FDG PET/CT in MM, using qualitative visual analysis or quantitative metabolic parameters, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) 6-9 . However, none of these methods have been extensively used in clinical practice or research projects, probably because of the complexity of the visual quantification 6,7 or due to the lack of standardization of MTV and TLG calculations 8-10 . Also, MTV and TLG only consider areas visually defined as lesions and ignore diffuse uptake of the bone marrow.

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“…So, many authors concluded that T1WI of MRI is unbiased at determining intraosseous tumor compared to STIR sequences or T2WI with fat suppression. 3 , 10 But the transition zone including the microinfiltration of tumor may be easily overlooked on T1WI, causing the underestimation of the tumor range. As shown in the present study, the tumor size measured on T1WI was 4.82 ± 0.87 cm, that was smaller than that measured on specimen under microscope (5.20 ± 0.89 cm, P < .05).…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Scope of Malignant Bone Tumor Using ADC Measurement on ADC Map

Chen

et al. 2019

Technol Cancer Res Treat

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Background: It is very important for surgeons to know the accurate borders of malignant bone tumors before they can precisely resect the tumors. The objective of the study is to investigate the usefulness of apparent diffusion coefficient value for estimating the extent of malignant bone tumor. Methods: VX2 tumor fragments were implanted into the tibiae of 30 rabbits. After 4 weeks, magnetic resonance plain scans were performed and then tumor specimens were cut into sagittal sections and partitioned into histology slices for dot-to-dot comparisons with microscopic findings. The sizes of the tumors measured separately on specimen, conventional magnetic resonance imaging sequences, and diffusion-weighted imaging (by measuring apparent diffusion coefficient value on apparent diffusion coefficient mapping) were compared statistically with each other. Results: The mean tumor sizes measured on specimen and apparent diffusion coefficient mapping (by calculating apparent diffusion coefficient value) were 5.20 ± 0.89 cm and 5.31 ± 0.87 cm, respectively; there was no significant difference between the 2 ( P > .05). The tumor sizes measured on T1WI, T2WI, T2WI with fat suppression were 4.82 ± 0.87 cm, 5.58 ± 0.87 cm, 5.63 ± 0.85 cm, respectively, and these values were significantly different from that measured on specimen (5.20 ± 0.89 cm, P < .05). Conclusion: The extent of the VX2 malignant bone tumor can be estimated accurately by measurement of apparent diffusion coefficient value.

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Current Concepts in MRI of Focal and Diffuse Malignancy of Bone Marrow

Cited by 24 publications

References 49 publications

GD2-Targeted Immunotherapy and Radioimmunotherapy

GD2-Targeted Immunotherapy and Radioimmunotherapy

Proposal for a Quantitative 18F-FDG PET/CT Metabolic Parameter to Assess the Intensity of Bone Involvement in Multiple Myeloma

Evaluating the Scope of Malignant Bone Tumor Using ADC Measurement on ADC Map

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