Total diffusion volume in MRI vs. total lesion glycolysis in PET/CT for tumor volume evaluation of multiple myeloma

Terao, Toshiki; Machida, Youichi; Narita, Kentaro; Kuzume, Ayumi; Tabata, Rikako; Tsushima, Takafumi; Miura, Daisuke; Takeuchi, Masami; Tateishi, Ukihide; Matsue, Kosei

doi:10.1007/s00330-021-07687-2

Cited by 13 publications

(13 citation statements)

References 32 publications

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“…As described in our previous report 10 , WB-DWI were obtained using a 1.5-Tesla unit (Magnetom Vision; Siemens Healthcare, Germany) with the following parameters: acquisition type, 2D; repetition time, 5400 ms; echo time, 74 ms; inversion time, 180 ms; slice thickness, 5 mm; and b -values, 0 and 900 s/mm 2 . The apparent diffusion coefficient (ADC) was calculated voxel by voxel for each image slice in b = 0 and 900 images.…”

Section: Methodsmentioning

confidence: 99%

“…We previously reported that the total diffusion volume (tDV) by pre-treatment WB-DWI was associated with a high bone marrow plasma cell (BMPC) count and poor prognosis in patients with MM 10 . Tumor volumes detected by WB-DWI and PET/CT were correlated, and we unexpectedly frequently found absence of a spleen signal in patients with NDMM and its reappearance after treatment.…”

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: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…There is evidence that the baseline metabolic tumor volume (MTV) is an important prognostic factor, e.g. in NHL, NSCLC and multiple myeloma, as well as in prostate cancer patients treated with the bone-seeking agent radium-223 (173)(174)(175)(176). Furthermore, MTV can be combined with metrics of tumor distance within a patient to not only represent volume, but also dissemination for better reflecting prognosis, as shown in NHL (175).…”

Section: Beyond Recist and Percistmentioning

confidence: 99%

Bone Metastases Are Measurable: The Role of Whole-Body MRI and Positron Emission Tomography

et al. 2021

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Metastatic tumor deposits in bone marrow elicit differential bone responses that vary with the type of malignancy. This results in either sclerotic, lytic, or mixed bone lesions, which can change in morphology due to treatment effects and/or secondary bone remodeling. Hence, morphological imaging is regarded unsuitable for response assessment of bone metastases and in the current Response Evaluation Criteria In Solid Tumors 1.1 (RECIST1.1) guideline bone metastases are deemed unmeasurable. Nevertheless, the advent of functional and molecular imaging modalities such as whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography (PET) has improved the ability for follow-up of bone metastases, regardless of their morphology. Both these modalities not only have improved sensitivity for visual detection of bone lesions, but also allow for objective measurements of bone lesion characteristics. WB-MRI provides a global assessment of skeletal metastases and for a one-step “all-organ” approach of metastatic disease. Novel MRI techniques include diffusion-weighted imaging (DWI) targeting highly cellular lesions, dynamic contrast-enhanced MRI (DCE-MRI) for quantitative assessment of bone lesion vascularization, and multiparametric MRI (mpMRI) combining anatomical and functional sequences. Recommendations for a homogenization of MRI image acquisitions and generalizable response criteria have been developed. For PET, many metabolic and molecular radiotracers are available, some targeting tumor characteristics not confined to cancer type (e.g. 18F-FDG) while other targeted radiotracers target specific molecular characteristics, such as prostate specific membrane antigen (PSMA) ligands for prostate cancer. Supporting data on quantitative PET analysis regarding repeatability, reproducibility, and harmonization of PET/CT system performance is available. Bone metastases detected on PET and MRI can be quantitatively assessed using validated methodologies, both on a whole-body and individual lesion basis. Both have the advantage of covering not only bone lesions but visceral and nodal lesions as well. Hybrid imaging, combining PET with MRI, may provide complementary parameters on the morphologic, functional, metabolic and molecular level of bone metastases in one examination. For clinical implementation of measuring bone metastases in response assessment using WB-MRI and PET, current RECIST1.1 guidelines need to be adapted. This review summarizes available data and insights into imaging of bone metastases using MRI and PET.

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“…Other studies also support the concept that MRI and FDG-PET/CT are complementary techniques. [7,86,[94][95][96][97].…”

Section: Fdg-pet In Comparison With Mri and Ctmentioning

confidence: 99%

“…In parallel with FDG-PET, DWI allows quantitative assessments, such as measures related to the apparent diffusion coefficient (ADC) and volumetric measures such as total diffusion volume (tDV). Terao et al [95] compared the prognostic significance of TLG and tDV for NDMM patients at baseline. They reported that although both tDV and TLG provided prognostic information about PFS, only TLG remained a prognostic factor for OS in the analyzed group.…”

Section: Fdg-pet In Comparison With Mri and Ctmentioning

confidence: 99%

Metabolic Volume Measurements in Multiple Myeloma

et al. 2021

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Multiple myeloma (MM) accounts for 10–15% of all hematologic malignancies, as well as 20% of deaths related to hematologic malignant tumors, predominantly affecting bone and bone marrow. Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) is an important method to assess the tumor burden of these patients. It is often challenging to classify the extent of disease involvement in the PET scans for many of these patients because both focal and diffuse bone lesions may coexist, with varying degrees of FDG uptake. Different metrics involving volumetric parameters and texture features have been proposed to objectively assess these images. Here, we review some metabolic parameters that can be extracted from FDG-PET/CT images of MM patients, including technical aspects and predicting MM outcome impact. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters known to be independent predictors of MM outcome. However, they have not been adopted in clinical practice due to the lack of measuring standards. CT-based segmentation allows automated, and therefore reproducible, calculation of bone metabolic metrics in patients with MM, such as maximum, mean and standard deviation of the standardized uptake values (SUV) for the entire skeleton. Intensity of bone involvement (IBI) is a new parameter that also takes advantage of this approach with promising results. Other indirect parameters obtained from FDG-PET/CT images, such as visceral adipose tissue glucose uptake and subcutaneous adipose tissue radiodensity, may also be useful to evaluate the prognosis of MM patients. Furthermore, the use and quantification of new radiotracers can address different metabolic aspects of MM and may have important prognostic implications.

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Total diffusion volume in MRI vs. total lesion glycolysis in PET/CT for tumor volume evaluation of multiple myeloma

Cited by 13 publications

References 32 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

Bone Metastases Are Measurable: The Role of Whole-Body MRI and Positron Emission Tomography

Metabolic Volume Measurements in Multiple Myeloma

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