PDF(Pubmed)
Abstract：
BACKGROUND: Dynamic contrast-enhanced-MRI (DCE-MRI) is able to study bone marrow angiogenesis in patients with multiple myeloma (MM) and asymptomatic precursor diseases but its role in the management of MM has not yet been established. The aims of this prospective study was to compare DCE-MRI-based parameters between all monoclonal plasma cell disease stages in order to find out discriminatory parameters and to seek correlations with other diffusion-weighted MRI and positron emission tomography (PET)-based biomarkers in a hybrid simultaneous whole-body-2-[18F]fluorodeoxyglucose (FDG)-PET/MRI (WB-2-[18F]FDG-PET/MRI) imaging approach.
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.
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.
摘要：
背景：动态对比增强MRI（DCE-MRI）能够研究多发性骨髓瘤（MM）和无症状前驱疾病患者的骨髓血管生成，但其在MM治疗中的作用尚未确定。这项前瞻性研究的目的是比较所有单克隆浆细胞疾病阶段之间基于DCE-MRI的参数，以找出歧视性参数，并寻求与其他扩散加权MRI和正电子发射断层扫描（PET）为基础的生物标志物的相关性。混合同步全身2-[18F]氟脱氧葡萄糖（FDG）-PET/MRI（WB-2-[18F]FDG-PET/MRI）成像方法。
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。
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。
