METHODS: Patients with newly diagnosed Monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM) or symptomatic MM according to international myeloma working group and underwent WB-2-[18F]FDG-PET/MRI imaging including bone marrow DCE sequences at the Nantes University Hospital were prospectively enrolled in this study before receiving treatment.
RESULTS: One hundred and sixty-seven patients (N = 167, mean age: 64 years ± 11 [Standard deviation], 66 males) were considered for the analysis. DCE-MRI-based Peak Enhancement Intensity (PEI), Time to PEI (TPEI) and their maximum intensity time ratio (MITR: PEI/TPEI) values were significantly different between the different monoclonal plasma cell disease stages, PEI values increasing and TPEI values decreasing progressively along the spectrum of plasma cell disorders, from MGUS stage to symptomatic multiple myeloma. PEI values were significantly higher in patients with diffuse bone marrow involvement (either in PET or in MRI images) than in those without diffuse bone marrow involvement, unlike TPEI values. PEI and TPEI values were not significantly different between patients with or without focal bone lesions.
CONCLUSIONS: Different DCE-MRI-based parameters (PEI, TPEI, MITR) could significantly differentiate all monoclonal plasma cell disease stages and complemented conventional MRI and PET-based biomarkers.
方法:新诊断的意义不明的单克隆丙种球蛋白病(MGUS)患者,根据国际骨髓瘤工作组,闷烧的多发性骨髓瘤(SMM)或有症状的MM,并在接受治疗前在南特大学医院接受了WB-2-[18F]FDG-PET/MRI成像,包括骨髓DCE序列。
结果:一百六十七名患者(N=167,平均年龄:64岁±11[标准偏差],66名男性)被考虑用于分析。基于DCE-MRI的峰值增强强度(PEI),PEI时光(TPEI)和它们的最年夜强度时光比(MITR:PEI/TPEI)值在分歧的单克隆浆细胞病分期之间有显著差别,PEI值增加和TPEI值逐渐降低,沿着浆细胞疾病的频谱,从MGUS分期到有症状的多发性骨髓瘤。弥漫性骨髓受累患者的PEI值(PET或MRI图像)明显高于无弥漫性骨髓受累患者。与TPEI值不同。有或没有局灶性骨病变的患者之间的PEI和TPEI值没有显着差异。
结论:基于DCE-MRI的不同参数(PEI,TPEI,MITR)可以显着区分所有单克隆浆细胞疾病阶段,并补充常规MRI和基于PET的生物标志物。