Whole-Body Functional MRI and PET/MRI in Multiple Myeloma

Mulé, Sebastien; Reizine, Edouard; Blanc-Durand, Paul; Baranès, Laurence; Zerbib, Pierre; Burns, Robert J.; Nouri, Refaat; Itti, Emmanuel; Luciani, Alain

doi:10.3390/cancers12113155

Cited by 27 publications

(21 citation statements)

References 38 publications

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“…In the present study, the MRI protocols mainly used conventional T1 weighted image (T1WI), T2 weighted image (T2WI), short TI inversion recovery (STIR), and contrast enhanced T1WI. However, a good diagnostic value of whole-body diffusion-weighted image (WBDWI) or PET/MRI has been reported in the treatment assessment of patients with MM [ 30 , 32 , 33 , 34 , 35 ]. The Myeloma Response Assessment and Diagnosis System (or MY-RADS) [ 16 ], a standardized evaluation method proposed in 2019, also recommends WBDWI according to its usefulness in previous reports [ 32 , 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of [18F]FDG PET/CT and MRI for Treatment Response Assessment in Multiple Myeloma: A Meta-Analysis

Yokoyama¹,

Tsuchiya²,

Tateishi³

2021

Diagnostics

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The present study was designed to assess the additional value of 2-deoxy-2[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) to magnetic resonance imaging (MRI) in the treatment response assessment of multiple myeloma (MM). We performed a meta-analysis of all available studies to compare the detectability of treatment response of [18F]FDG PET/CT and MRI in treated MM. We defined detecting a good therapeutic effect as positive, and residual disease as negative. We determined the sensitivities and specificities across studies, calculated the positive and negative likelihood ratios (LR), and made summary receiver operating characteristic curves (SROC) using hierarchical regression models. The pooled analysis included six studies that comprised 278 patients. The respective performance characteristics (95% confidence interval (CI)) of [18F]FDG PET/CT and MRI were as follows: sensitivity of 80% (56% to 94%) and 25% (19% to 31%); specificity of 58% (44% to 71%) and 83% (71% to 91%); diagnostic odds ratio (DOR) of 6.0 (3.0–12.0) and 1.7 (0.7–2.7); positive LR of 1.8 (1.3–2.4) and 1.4 (0.7–2.7); and negative LR of 0.33 (0.21–0.53) and 0.81 (0.62–1.1). In the respective SROC curves, the area under the curve was 0.77 (SE, 0.038) and 0.59 (SE, 0.079) and the Q* index was 0.71 and 0.57. Compared with MRI, [18F]FDG PET/CT had higher sensitivity and better DOR and SROC curves. Compared with MRI, [18F]FDG PET/CT had greater ability to detect the treatment assessment of MM.

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Section: Discussionmentioning

confidence: 99%

Comparison of [18F]FDG PET/CT and MRI for Treatment Response Assessment in Multiple Myeloma: A Meta-Analysis

Yokoyama¹,

Tsuchiya²,

Tateishi³

2021

Diagnostics

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“…Larger standardized prospective studies are, however, warranted to confirm these results. Additionally, the complementary role of 18 F-FDG PET/CT and DW-MRI should be further addressed, for example through studies performed on PET/MRI hybrid systems (75).…”

Section: F-fdg Pet/ct Compared With Diffusion-weighted Mri After Asctmentioning

confidence: 99%

18F-FDG PET/CT and MRI in the Management of Multiple Myeloma: A Comparative Review

et al. 2022

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During the last two decades, the imaging landscape of multiple myeloma (MM) has evolved with whole-body imaging techniques such as fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET/CT) and MRI replacing X-ray skeletal survey. Both imaging modalities have high diagnostic performance at the initial diagnosis of MM and are key players in the identification of patients needing treatment. Diffusion-weighted MRI has a high sensitivity for bone involvement, while 18F-FDG PET/CT baseline parameters carry a strong prognostic value. The advent of more efficient therapeutics, such as immunomodulatory drugs and proteasome inhibitors, has called for the use of sensitive imaging techniques for monitoring response to treatment. Diffusion-weighted MRI could improve the specificity of MRI for tumor response evaluation, but questions remain regarding its role as a prognostic factor. Performed at key time points of treatment in newly diagnosed MM patients, 18F-FDG PET/CT showed a strong association with relapse risk and survival. The deployment of minimal residual disease detection at the cellular or the molecular level may raise questions on the role of these imaging techniques, which will be addressed. This review summarizes and outlines the specificities and respective roles of MRI and 18F-FDG PET/CT in the management of MM.

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“…A systematic review concluded that data on this topic are too heterogeneous, with biased accrual and lack of independent reference standard, which also precluded performing a meta-analysis [125]. Hence, it remains unclear which modality may be best suited for response assessment and the evaluation of both techniques using either side-by-side or on PET/MRI hybrid scanners should provide information on their respective effectiveness [126] (Figs. 5,6,10).…”

Section: Comparisons Of Pet and Mri And Value Of The Pet/ Mri Technologymentioning

confidence: 99%

“…5,6,10). PET/MRI indeed combines the two most effective imaging modalities in MM and allows a one-step exhaustive evaluation and comparison between both techniques at diagnosis, at the time of response assessment and MRD detection [99,126].…”

Section: Comparisons Of Pet and Mri And Value Of The Pet/ Mri Technologymentioning

confidence: 99%

Imaging of treatment response and minimal residual disease in multiple myeloma: state of the art WB-MRI and PET/CT

et al. 2021

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Bone imaging has been intimately associated with the diagnosis and staging of multiple myeloma (MM) for more than 5 decades, as the presence of bone lesions indicates advanced disease and dictates treatment initiation. The methods used have been evolving, and the historical radiographic skeletal survey has been replaced by whole body CT, whole body MRI (WB-MRI) and [18F]FDG-PET/CT for the detection of bone marrow lesions and less frequent extramedullary plasmacytomas.Beyond diagnosis, imaging methods are expected to provide the clinician with evaluation of the response to treatment. Imaging techniques are consistently challenged as treatments become more and more efficient, inducing profound response, with more subtle residual disease. WB-MRI and FDG-PET/CT are the methods of choice to address these challenges, being able to assess disease progression or response and to detect “minimal” residual disease, providing key prognostic information and guiding necessary change of treatment.This paper provides an up-to-date overview of the WB-MRI and PET/CT techniques, their observations in responsive and progressive disease and their role and limitations in capturing minimal residual disease. It reviews trials assessing these techniques for response evaluation, points out the limited comparisons between both methods and highlights their complementarity with most recent molecular methods (next-generation flow cytometry, next-generation sequencing) to detect minimal residual disease. It underlines the important role of PET/MRI technology as a research tool to compare the effectiveness and complementarity of both methods to address the key clinical questions.

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Whole-Body Functional MRI and PET/MRI in Multiple Myeloma

Cited by 27 publications

References 38 publications

Comparison of [18F]FDG PET/CT and MRI for Treatment Response Assessment in Multiple Myeloma: A Meta-Analysis

Comparison of [18F]FDG PET/CT and MRI for Treatment Response Assessment in Multiple Myeloma: A Meta-Analysis

18F-FDG PET/CT and MRI in the Management of Multiple Myeloma: A Comparative Review

Imaging of treatment response and minimal residual disease in multiple myeloma: state of the art WB-MRI and PET/CT

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