Diffusion-weighted whole-body MRI for evaluation of early response in multiple myeloma
Diffusion-weighted whole-body MRI for evaluation of early response in multiple myeloma
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DOI：
10.1016/j.crad.2017.05.004
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发表时间：
2017-10-01
影响因子：
2.6
通讯作者：
Zambello, R.
中科院分区：
文献类型：
--
作者：
Lacognata, C.;Crimi, F.;Zambello, R.
目的：根据国际骨髓瘤工作组(IMWG)标准，评价骨髓瘤皮损诱导治疗前后表观弥散系数(ADC)的变化及其与患者疗效的相关性。材料与方法：对18例确诊为症状性多发性骨髓瘤患者进行前瞻性的全身磁共振弥散加权成像(DWI-MRI)检查。定量分析骨髓瘤病变的ADC图，分为局灶型、弥漫型(中、重度)和“盐和胡椒”型。通过定量图像分析对病变进行评估，包括在三个测量中测量平均ADC值。结果：治疗有效的患者皮损的ADC值有统计学意义的增加。有趣的是，局灶性病变有效组的ADC值显著增加，而非局灶性病变(弥漫型和“盐与胡椒型”)的ADC值在应答组和无应答组之间无显著差异。结论：DWI-MRI可以根据局灶性病变的ADC值的变化提供有助于监测早期治疗反应的额外定量信息。(C)2017年皇家放射科医师学会。爱思唯尔有限公司出版。保留所有权利。
AIM: To evaluate the modifications of the apparent diffusion coefficient (ADC) in myelomatous lesions before and after induction treatment and the correlation with patient response to therapy according to International Myeloma Working Group (IMWG) criteria.MATERIALS AND METHODS: A homogeneous group of 18 patients with a diagnosis of symptomatic multiple myeloma who underwent whole-body MRI with diffusion-weighted imaging (DWI-MRI) before and after bortezomib-based induction chemotherapy were evaluated prospectively. Quantitative analysis of ADC maps of myelomatous lesions was performed with the following pattern types: focal pattern, diffuse pattern (moderate and severe), and "salt and pepper" pattern. Lesions were evaluated by quantitative image analysis including measurement of the mean ADC in three measurements. Imaging results were compared to laboratory results as the clinical reference standard.RESULTS: A statistically significant increase in ADC values were found in the lesions of patients that responded to treatment. Interestingly, focal lesions showed a strongly significant increase in ADC values in responders, whereas no significant variation in ADC value in nonfocal lesions (diffuse pattern and "salt and peppers" pattern) between responders and non-responders group was demonstrated.CONCLUSIONS: DWI-MRI could provide additional quantitative information useful in monitoring early therapy response according to ADC changes of focal lesions. (C) 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.