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Development of a whole spinal MRI-based tumor burden scoring method in participants with multiple myeloma: a pilot study of prognostic significance

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Abstract

The aim of the study was to develop a new whole spinal MRI-based tumor burden scoring method in participants with newly diagnosed multiple myeloma (MM) and to explore its prognostic significance. We prospectively recruited participants with newly diagnosed MM; performed whole spinal MRI (sagittal FSE T1WI, sagittal IDEAL T2WI, and axial FLAIR T2WI) on them; and collected their clinical data, early treatment response, progression-free survival (PFS), and overall survival (OS). We developed a new tumor burden scoring method according to the extent of bone marrow infiltration in five MRI patterns. All participants were divided into good response and poor response groups after four treatment cycles. Univariate, multivariate analyses, and ROC were used to determine the performance of independent predictors. Thresholds for PFS and OS were calculated using X-tile, and their prognostic significance were assessed by Kaplan–Meier. The Kruskal–Wallis H test was used to compare the differences of tumor burden score between the revised International Staging System (R-ISS) stages. The new tumor burden scoring method was used in 62 participants (median score, 12; range, 0–18). The tumor burden score (OR 1.266, p = 0.002) was an independent predictor of poor response and the AUC was 0.838. Higher tumor burden scores were associated with shorter PFS (p = 0.002) and OS (p = 0.011). The tumor burden score was higher in R-ISS-III than in R-ISS-I and R-ISS-II (p = 0.016 and p = 0.006, respectively). The tumor burden score was an excellent predictor of prognosis and may serve as a supplemental marker for R-ISS.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This study has received funding by National Natural Science Foundation of China (NSFC 82071898).

Author information

Author notes

  1. Sha Cui and Yinnan Guo contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China

    Sha Cui & Wenjin Bian

  2. Department of Radiology, Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi, China

    Sha Cui, Jianting Li, Wenqi Wu, Wenjia Zhang, Qian Zheng, Jun Wang & Jinliang Niu

  3. Department of Pain, Fifth Hospital of Shanxi Medical University, Taiyuan, Shanxi, China

    Yinnan Guo

  4. GE Healthcare, MR Research China, Beijing, China

    Haonan Guan

Authors
  1. Sha Cui
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  2. Yinnan Guo
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  3. Jianting Li
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  4. Wenjin Bian
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  5. Wenqi Wu
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  9. Jun Wang
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  10. Jinliang Niu
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Contributions

Conception and design of study: Sha Cui, Yinnan Guo, and Jinliang Niu; collection and assembly of data: Sha Cui, Jianting Li, Wenjin Bian, and Wenqi Wu; follow-up of participants: Sha Cui and Yinnan Guo; statistical analysis: Sha Cui and Wenjia Zhang; analysis and interpretation of data: Sha Cui, Qian Zheng, and Haonan Guan; manuscript writing: Sha Cui and Yinnan Guo; critical review: Jinliang Niu and Jun Wang.

Corresponding author

Correspondence to Jinliang Niu.

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Ethics approval

This study received approval from the ethics committee of the Second Hospital of Shanxi Medical University (protocol number 2020–040).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Cui, S., Guo, Y., Li, J. et al. Development of a whole spinal MRI-based tumor burden scoring method in participants with multiple myeloma: a pilot study of prognostic significance. Ann Hematol 103, 1665–1673 (2024). https://doi.org/10.1007/s00277-024-05642-x

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  • DOI: https://doi.org/10.1007/s00277-024-05642-x

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