Predictive role of diffusion‐weighted whole‐body MRI (DW‐MRI) imaging response according to MY‐RADS criteria after autologous stem cell transplantation in patients with multiple myeloma and combined evaluation with MRD assessment by flow cytometry

Belotti, Angelo; Ribolla, Rossella; Cancelli, Valeria; Villanacci, Alberta; Angelini, Valentina; Chiarini, Marco; Giustini, Viviana; Facchetti, Giulia Vittoria; Roccaro, Aldo M.; Ferrari, Samantha; Peli, Annalisa; Bottelli, Chiara; Cattaneo, Chiara; Crippa, Claudia; Micilotta, Monica; Frittoli, Barbara; Grazioli, Luigi; Rossi, Giuseppe; Tucci, Alessandra

doi:10.1002/cam4.4136

Cited by 24 publications

(27 citation statements)

References 21 publications

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“…WB-MRI is currently used to detect focal lesions and determine the indication of treatment according to the IMWG criteria 12 . Moreover, recent studies demonstrated the efficacy of repetitive WB-MRI for treatment response and prognostic impact 7 – 9 . LSV, which could be additionally evaluated in the WB-DWI of diagnostic process, could become an additional and simplified prognostic indicator in patients with NDMM.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with MM, the use of WB-DWI in diagnosis is superior to whole-body radiographs 4 and is equal to or more sensitive than PET/CT for the detection of focal lesions 1 , 5 , 6 . Although WB-DWI is mainly used in diagnostic process, there are several reports regarding the use of WB-DWI to monitor the patient’s response to treatment 7 – 9 . Myeloma Response Assessment and Diagnosis System (MY-RADS) recommendation was designed to report WB-MRI and assess treatment response 8 .…”

Section: Introductionmentioning

confidence: 99%

“…Myeloma Response Assessment and Diagnosis System (MY-RADS) recommendation was designed to report WB-MRI and assess treatment response 8 . Moreover, recently, patients who achieved the complete imaging response after autologous stem-cell transplantation (ASCT) showed significant superior survival than those with imaging residual disease 9 .…”

Section: Introductionmentioning

confidence: 99%

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Association of loss of spleen visualization on whole-body diffusion-weighted imaging with prognosis and tumor burden in patients with multiple myeloma

Terao

Machida

Tateishi

et al. 2021

Sci Rep

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This study investigated the clinical significance of loss of spleen visualization (LSV) on whole-body diffusion-weighted imaging (WB-DWI) in patients with multiple myeloma (MM). The WB-DWI of 96 patients with newly diagnosed MM (NDMM) and 15 patients with smoldering MM (sMM) were retrospectively reviewed. LSV was observed in 56 patients with NDMM (58.3%) and 1 patient with sMM (6.7%). Patients with NDMM with LSV had a higher median infiltration of bone marrow plasma cells (80.0% vs. 50.0%, p < 0.001) and median total diffusion volume (median; 540.2 vs. 137.0 mL, p = 0.003) than patients without LSV. Patients with LSV had a lower spleen-to-spinal cord ratio (0.36 vs. 0.96, p < 0.001) and worse 2-year overall survival (OS) (84.6% vs. 100%, p = 0.032). Patients who did not recover spleen visualization during treatment had a worse prognosis, even when they obtained very good partial response (median progression-free survival: 13.2 months). Spleen histopathological findings revealed higher cellularity and diffuse myeloma cell infiltration in a patient with LSV and splenic amyloidosis without extramedullary hematopoiesis in a patient without LSV. Therefore, LSV indicates worse prognosis for patients with MM, even when the patient responds to treatment. Further studies are warranted to clarify the immunological role of spleen in MM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of loss of spleen visualization on whole-body diffusion-weighted imaging with prognosis and tumor burden in patients with multiple myeloma

Terao

Machida

Tateishi

et al. 2021

Sci Rep

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“…DW-MRI has been applied to MM because of its relatively excellent sensitivity compared with FDG PET/CT and whole-body low-dose CT (9). DW-MRI has been proven to be an effective tool not only for MM diagnosis but also for outcome prediction after chemotherapy, exerting an increasing influence on the treatment management of MM (10). Even though DW-MRI is now gradually replacing traditional imaging methods of MM diagnosis (11), its implementation is not complete in predicting survival due to lack of relevant studies.…”

Section: Introductionmentioning

confidence: 99%

The Apparent Diffusion Coefficient of Diffusion-Weighted Whole-Body Magnetic Resonance Imaging Affects the Survival of Multiple Myeloma Independently

et al. 2022

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BackgroundDiffusion-weighted whole-body MRI (DW-MRI) is increasingly used to evaluate bone diseases of multiple myeloma (MM), but there is lack of quantitative indicator for DW-MRI to reflect the prognosis of MM. Apparent diffusion coefficient (ADC) values in DW-MRI has potential correlations between some indexes of MM, but the influence of ADC on MM survival needs to be further verified.MethodsA total of 381 newly diagnosed MM patients were enrolled in the study to analyze the effect of ADC values in DW-MRI on progression-free survival (PFS) and overall survival (OS). The Kaplan–Meier method was used to perform univariate survival analysis, and the Cox proportional hazards model was used for multivariate analysis. In addition to the ADC value, genetic and serological indexes were also included.ResultsThe survivals were observed in univariate ADC stratification with median PFS of 52.0, 45.0, 34.0, and 26.0 months (the unit of ADC value was 10−3 mm2/s; the ADC ranges were ADC < 0.4886, 0.4886 ≤ ADC < 0.6545, 0.6545 ≤ ADC < 0.7750, and ADC ≥ 0.7750; 95% CI, 43.759–62.241, 46.336–53.664, 39.753–46.247, and 27.812–32.188). The OS were 81.0, 61.0, 47.0, and 36.0 months (p < 0.001; 95% CI, 71.356–82.644, 67.630–70.370, 57.031–60.969, and 36.107–43.893). In Cox proportional hazards model, the ADC value was considered to be an independent risk factor affecting PFS and OS of MM (both p < 0.001).ConclusionsThis study supports that ADC in DW-MRI may independently stratify MM patients and better predict their prognosis. The combined use of DW-MRI and other parameters allows more accurate evaluation of MM survival.Trial Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=49012, ChiCTR2000029587.

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“…Whole-body diffusion-weighted MRI (WB-DWI) maintains the advantages of MRI to identify small lesions in bone marrow at diagnosis, but it also allows the quantification of residual disease through the apparent diffusion coefficient without the need for intravenous contrast and shows a good correlation with bone marrow infiltration, thus being superior to conventional MRI (91,92). Some preliminary studies have confirmed a benefit in PFS linked to the achievement of WB-DWI negativity after ASCT (93,94), additionally being a technique without ionizing radiation, which may overcome some of the limitations of PET-CT (95).…”

Section: Towards a Comprehensive Evaluation Of Tumor Burden: The Futurementioning

confidence: 99%

Tumor Reduction in Multiple Myeloma: New Concepts for New Therapeutics

Alonso

Lahuerta

2022

Front. Oncol.

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The development of new resources for a more accurate diagnosis and response assessment in multiple myeloma has been a long process for decades, mainly since the middle of the 20th century. During this time, the succession of technical advances has run parallel to the better knowledge of disease biology and the availability of novel therapeutic strategies. The cornerstone of standardized criteria to uniformly evaluate the disease response in myeloma dates back to the 1990s when the key role of complete remission was established. Since then, different updates have been implemented according to available scientific evidences not always without certain controversies. The progressive improvements in survival results of myeloma patients and the growing quality of responses due to the novel therapies have led to the need of developing new tools for better monitoring of tumor burden. In this way, the concept of minimal residual disease and its key value based on the prognostic significance and the clinical relevance has been consolidated during the last years, overcoming the value of conventional response criteria or classical adverse prognosis markers. Nevertheless, its precise role in the clinical management of myeloma patients to detect early treatment failure and trigger early rescue strategies is still pending to be defined. In this review, we revisit the major milestones in the understanding of tumor reduction in multiple myeloma until the most recent imaging techniques or liquid biopsy approaches, including a critical view of conventional response criteria, whose backbone has remained unchanged during the last 20 years.

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Predictive role of diffusion‐weighted whole‐body MRI (DW‐MRI) imaging response according to MY‐RADS criteria after autologous stem cell transplantation in patients with multiple myeloma and combined evaluation with MRD assessment by flow cytometry

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 24 publications

References 21 publications

Association of loss of spleen visualization on whole-body diffusion-weighted imaging with prognosis and tumor burden in patients with multiple myeloma

Association of loss of spleen visualization on whole-body diffusion-weighted imaging with prognosis and tumor burden in patients with multiple myeloma

The Apparent Diffusion Coefficient of Diffusion-Weighted Whole-Body Magnetic Resonance Imaging Affects the Survival of Multiple Myeloma Independently

Tumor Reduction in Multiple Myeloma: New Concepts for New Therapeutics

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