Journal
EUROPEAN RADIOLOGY
Volume 27, Issue 12, Pages 5325-5336Publisher
SPRINGER
DOI: 10.1007/s00330-017-4907-8
Keywords
MRI; Whole body; Multiple myeloma; Bortezomib; Response monitoring
Funding
- Cancer Research UK/Engineering and Physical Sciences Research Council (CRUK/EPSRC) award from the University College London/King's College London (UCL/KCL) Comprehensive Cancer Imaging Centre (CCIC) [C1519/A10331, C1519/A16463]
- UK Engineering and Physical Sciences Research Council (EPSRC) [EP/I018700/1, EP/H046410/1]
- National Institute for Health Research (NIHR)
- University College London Hospitals (UCLH) Biomedical Research Centre (BRC)
- Cancer Research UK (CRUK) University College London Experimental Cancer Medicine Centre
- Cancer Research UK [16463] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0513-10019, CL-2007-18-015] Funding Source: researchfish
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To evaluate whole-body MRI (WB-MRI) parameters significantly associated with treatment response in multiple myeloma (MM). Twenty-one MM patients underwent WB-MRI at diagnosis and after two cycles of chemotherapy. Scans acquired at 3.0 T included T2, diffusion-weighted-imaging (DWI) and mDixon pre- and post-contrast. Twenty focal lesions (FLs) matched on DWI and post-contrast mDixon were selected for each time point. Estimated tumour volume (eTV), apparent diffusion coefficient (ADC), enhancement ratio (ER) and signal fat fraction (sFF) were derived. Clinical treatment response to chemotherapy was assessed using conventional criteria. Significance of temporal parameter change was assessed by the paired t test and receiver operating characteristics/area under the curve (AUC) analysis was performed. Parameter repeatability was assessed by interclass correlation (ICC) and Bland-Altman analysis of 10 healthy volunteers scanned at two time points. Fifteen of 21 patients responded to treatment. Of 254 FLs analysed, sFF (p < 0.0001) and ADC (p = 0.001) significantly increased in responders but not non-responders. eTV significantly decreased in 19/21 cases. Focal lesion sFF was the best discriminator of treatment response (AUC 1.0). Bone sFF repeatability was excellent (ICC 0.98) and better than bone ADC (ICC 0.47). WB-MRI derived focal lesion sFF shows promise as an imaging biomarker of treatment response in newly diagnosed MM.
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