Comparison of whole-body MR imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy
Comparison of whole-body MR imaging and conventional X-ray examination in patients with multiple myeloma and implications for therapy
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DOI：
10.1007/s00277-008-0621-6
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发表时间：
2009-05-01
影响因子：
3.5
通讯作者：
Metzgeroth, Georgia
中科院分区：
文献类型：
--
作者：
Dinter, Dietmar Joerg;Neff, Wolfgang K.;Metzgeroth, Georgia
骨骼X线检查是诊断多发性骨髓瘤患者的既定方法;然而，全身磁共振成像（wb-MRI）已成为一种重要的附加工具。本研究的目的是比较传统X线检查（X线检查）与wb-MRI结果的不同浸润模式，以确定wb-MRI对治疗变化的影响。在60例平均年龄为65.1 ± 11.7岁的患者中，wb-MRI检查与最近的X线检查相关。结果由两名放射科医师独立评估，并在两种模式中描述浸润模式。随后，根据Salmon和Durie以及Salmon和Durie PLUS对疾病进行了分期。此外，使用三范围Likert类型量表评估MRI对治疗中潜在变化的影响。总共比较了480个骨骼区域。在183个骨骼区域中，wb-MRI发现浸润程度增加。在胸部、脊柱、骨盆和双下肢中，两种模式之间存在显著差异（p < 0.05）。基于wb-MRI，使用Durie和Salmon PLUS分类的60例患者中有19例的肿瘤分期升级。在这19例患者中的10例（42%）中，由于浸润程度、髓外肿瘤扩展和/或进一步骨折风险，wb-MRI结果对于决定开始进一步治疗至关重要。全身MRI提供了更详细的骨髓浸润模式评估，并强烈影响治疗策略。
Skeletal X-ray survey is the established method of diagnosis in patients with multiple myeloma; however, whole-body magnetic resonance imaging (wb-MRI) has become an important additional tool. The aim of this study was to compare the different patterns of infiltration on conventional X-ray examinations (X-ray survey) with findings from wb-MRI to subsequently determine the influence of wb-MRI on therapy changes. In 60 patients with a mean age of 65.1 +/- 11.7 years, wb-MRI examinations were correlated with a recent X-ray survey. The results were independently assessed by two radiologists and the patterns of infiltration were described in both modalities. Subsequently, the disease was staged according to Salmon and Durie and Salmon and Durie PLUS. Additionally, the influence of MRI on potential changes in therapy was assessed using a three-range Likert-type scale. In all, 480 skeletal regions were compared. In 183 skeletal regions, an increased degree of infiltration was identified on wb-MRI. Significant differences (p < 0.05) between the modalities could be found in the thorax, spine, pelvis, and both lower extremities. Based on wb-MRI, tumor stage was upgraded in 19 of the 60 patients using the Durie and Salmon PLUS classification. In ten out of these 19 patients (42%), the wb-MRI result was essential for making the decision to initiate further therapy due to the degree of infiltration, extramedullary tumor extension, and/or further risk of fracture. Whole-body MRI provides a more detailed assessment of the pattern of bone marrow infiltration and strongly influences therapeutic strategies.