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Iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) imaging of multiple myeloma: initial clinical efficiency results

  • Magnetic Resonance
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Abstract

Objectives

To evaluate the effectiveness of the iterative decomposition of water and fat with echo asymmetric and least-squares estimation (IDEAL) MRI to quantify tumour infiltration into the lumbar vertebrae in myeloma patients without visible focal lesions.

Methods

The lumbar spine was examined with 3 T MRI in 24 patients with multiple myeloma and in 26 controls. The fat-signal fraction was calculated as the mean value from three vertebral bodies. A post hoc test was used to compare the fat-signal fraction in controls and patients with monoclonal gammopathy of undetermined significance (MGUS), asymptomatic myeloma or symptomatic myeloma. Differences were considered significant at P < 0.05. The fat-signal fraction and β2-microglobulin-to-albumin ratio were entered into the discriminant analysis.

Results

Fat-signal fractions were significantly lower in patients with symptomatic myelomas (43.9 ±19.7%, P < 0.01) than in the other three groups. Discriminant analysis showed that 22 of the 24 patients (92%) were correctly classified into symptomatic or non-symptomatic myeloma groups.

Conclusions

Fat quantification using the IDEAL sequence in MRI was significantly different when comparing patients with symptomatic myeloma and those with asymptomatic myeloma. The fat-signal fraction and β2-microglobulin-to-albumin ratio facilitated discrimination of symptomatic myeloma from non-symptomatic myeloma in patients without focal bone lesions.

Key Points

• A new magnetic resonance technique (IDEAL) offers new insights in multiple myeloma.

• Fat-signal fractions were lower in patients with symptomatic myelomas than in those with asymptomatic myelomas.

• The β2-microglobulin-to-albumin ratio also aided discrimination of symptomatic myeloma.

• The fat-signal fraction may provide information about the myeloma cell mass.

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Acknowledgement

M.T. was funded by the Tsuchiya Foundation (Japan) through an unrestricted research grant.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshimashi, 734-8551, Japan

    Miyuki Takasu, Chihiro Tani, Yasuko Sakoda, Miho Ishikawa, Keizo Tanitame, Shuji Date, Yuji Akiyama & Kazuo Awai

  2. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3, Kasumi, Minamiku, Hiroshimashi, 734-8551, Japan

    Akira Sakai

  3. Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, 1-9-6, Sendamachi, Nakaku, Hiroshimashi, 730-8619, Japan

    Hideki Asaoku

  4. Kajima Clinic, 2-6-6, Miyahara, Kureshi, Hiroshimaken, 737-0024, Japan

    Toshio Kajima

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  1. Miyuki Takasu
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  2. Chihiro Tani
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Correspondence to Miyuki Takasu.

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Takasu, M., Tani, C., Sakoda, Y. et al. Iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) imaging of multiple myeloma: initial clinical efficiency results. Eur Radiol 22, 1114–1121 (2012). https://doi.org/10.1007/s00330-011-2351-8

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  • DOI: https://doi.org/10.1007/s00330-011-2351-8

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