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Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation

  • Magnetic Resonance
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Abstract

Objectives

To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation.

Methods

Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters.

Results

Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission.

Conclusions

WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission.

Key Points

• Whole body magnetic resonance imaging (WBMRI) is increasingly used for oncological purposes

• WBMRI allows localisation of intra- and extramedullary myeloma manifestations after SCT

• However, WBMRI and serum analyses do not fully concur when assessing response

• Thus, WBMRI offers limited incremental value over laboratory tests to determine remission

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Abbreviations

WBMRI:

whole-body magnetic resonance imaging

MRI:

magnetic resonance imaging

SCT:

stem cell transplantation

MM:

multiple myeloma

CR:

complete remission

PD:

progressive disease

PR:

partial remission

SD:

stable disease

References

  1. Bataille R, Harousseau JL (1997) Multiple myeloma. N Engl J Med 336:1657–1664

    Article  PubMed  CAS  Google Scholar 

  2. Palumbo A, Anderson K (2011) Multiple myeloma. N Engl J Med 364:1046–1060

    Article  PubMed  CAS  Google Scholar 

  3. Sirohi B, Powles R (2004) Multiple myeloma. Lancet 363:875–887

    Article  PubMed  Google Scholar 

  4. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  PubMed  Google Scholar 

  5. Bensinger WI (2009) Role of autologous and allogeneic stem cell transplantation in myeloma. Leukemia 23:442–448

    Article  PubMed  CAS  Google Scholar 

  6. Lokhorst H, Einsele H, Vesole D et al. International Myeloma Working Group consensus statement regarding the current status of allogeneic stem-cell transplantation for multiple myeloma. J Clin Oncol 28:4521–4530

  7. Kroger N (2007) Mini-Midi-Maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation. Leukemia 21:1851–1858

    Article  PubMed  CAS  Google Scholar 

  8. Attal M, Harousseau JL, Facon T et al (2003) Single versus double autologous stem-cell transplantation for multiple myeloma. N Engl J Med 349:2495–2502

    Article  PubMed  CAS  Google Scholar 

  9. Barlogie B, Tricot GJ, van Rhee F et al (2006) Long-term outcome results of the first tandem autotransplant trial for multiple myeloma. Br J Haematol 135:158–164

    Article  PubMed  Google Scholar 

  10. Harousseau JL, Dreyling M (2009) Multiple myeloma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 20:97–99

    Article  PubMed  Google Scholar 

  11. Kroger N, Bacher U, Bader P et al. NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: report from the Committee on Disease-Specific Methods and Strategies for Monitoring Relapse following Allogeneic Stem Cell Transplantation. Part I: Methods, acute leukemias, and myelodysplastic syndromes. Biol Blood Marrow Transplant 16:1187–1211

  12. Rajkumar SV, Harousseau JL, Durie B et al. Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1. Blood 117:4691–4695

  13. Durie BG, Harousseau JL, Miguel JS et al (2006) International uniform response criteria for multiple myeloma. Leukemia 20:1467–1473

    Article  PubMed  CAS  Google Scholar 

  14. Dimopoulos M, Terpos E, Comenzo RL et al (2009) International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia 23:1545–1556

    Article  PubMed  CAS  Google Scholar 

  15. D'Sa S, Abildgaard N, Tighe J, Shaw P, Hall-Craggs M (2007) Guidelines for the use of imaging in the management of myeloma. Br J Haematol 137:49–63

    PubMed  Google Scholar 

  16. Derlin T, Weber C, Habermann CR et al (18)F-FDG PET/CT for detection and localization of residual or recurrent disease in patients with multiple myeloma after stem cell transplantation. Eur J Nucl Med Mol Imaging. doi: 10.1007/s00259-011-1993-8

  17. Fonti R, Salvatore B, Quarantelli M et al (2008) 18 F-FDG PET/CT, 99mTc-MIBI, and MRI in evaluation of patients with multiple myeloma. J Nucl Med 49:195–200

    Article  PubMed  Google Scholar 

  18. Shortt CP, Carty F, Murray JG. The role of whole-body imaging in the diagnosis, staging, and follow-up of multiple myeloma. Semin Musculoskelet Radiol 14:37–46

  19. Durie BG (2006) The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer 42:1539–1543

    Article  PubMed  Google Scholar 

  20. Lecouvet FE, Dechambre S, Malghem J, Ferrant A, Vande Berg BC, Maldague B (2001) Bone marrow transplantation in patients with multiple myeloma: prognostic significance of MR imaging. AJR Am J Roentgenol 176:91–96

    PubMed  CAS  Google Scholar 

  21. Lin C, Luciani A, Belhadj K et al. Multiple myeloma treatment response assessment with whole-body dynamic contrast-enhanced MR imaging. Radiology 254:521–531

  22. Blade J, Samson D, Reece D et al (1998) Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol 102:1115–1123

    Article  PubMed  CAS  Google Scholar 

  23. Kramer MS, Feinstein AR (1981) Clinical biostatistics. LIV. The biostatistics of concordance. Clin Pharmacol Ther 29:111–123

    Article  PubMed  CAS  Google Scholar 

  24. Bauerle T, Hillengass J, Fechtner K et al (2009) Multiple myeloma and monoclonal gammopathy of undetermined significance: importance of whole-body versus spinal MR imaging. Radiology 252:477–485

    Article  PubMed  Google Scholar 

  25. Horger M, Weisel K, Horger W, Mroue A, Fenchel M, Lichy M. Whole-body diffusion-weighted MRI with apparent diffusion coefficient mapping for early response monitoring in multiple myeloma: preliminary results. AJR Am J Roentgenol 196:W790-795

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Peter Bannas, Hannah B. Hentschel, Thorsten A. Bley, Thorsten Derlin, Jin Yamamura, Gerhard Adam & Christoph Weber

  2. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    András Treszl & Christine Eulenburg

  3. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Thomas Stübig & Nicolaus Kröger

Authors
  1. Peter Bannas
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  2. Hannah B. Hentschel
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  3. Thorsten A. Bley
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  4. András Treszl
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  5. Christine Eulenburg
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  6. Thorsten Derlin
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  7. Jin Yamamura
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  8. Gerhard Adam
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  9. Thomas Stübig
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  10. Nicolaus Kröger
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  11. Christoph Weber
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Correspondence to Peter Bannas.

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Bannas, P., Hentschel, H.B., Bley, T.A. et al. Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation. Eur Radiol 22, 2007–2012 (2012). https://doi.org/10.1007/s00330-012-2445-y

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  • DOI: https://doi.org/10.1007/s00330-012-2445-y

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