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Total diffusion volume in MRI vs. total lesion glycolysis in PET/CT for tumor volume evaluation of multiple myeloma

  • Oncology
  • Published:
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Abstract

Objective

This study compared the tumor burden and prognostic impact of total diffusion volume (tDV) and total lesion glycolysis (TLG) in the same patients with newly diagnosed multiple myeloma (NDMM) simultaneously. We also examined the relationship between these imaging tumor volumes (TVs) and plasma cell (PC) TV in bone marrow (BM) specimens.

Methods

We retrospectively reviewed the data of 63 patients with newly diagnosed multiple myeloma (NDMM) from April 2016 to March 2018. tDV was calculated from whole-body diffusion-weighted imaging and TLG was calculated from the average standard uptake value and the metabolic tumor volume, respectively. Cellularity of BM hematopoietic tissue and the percentage of BM PCs were used as a reference of PC volume in the BM.

Results

The Spearman correlation coefficient between tDV and TLG was moderate (ɤs = 0.588, p < 0.001) when PET false-negative patients were excluded. There were positive correlations between the BM plasma cell volume (BMPCV) and the imaging TVs (ɤs = 0.505, vs. tDV; and 0.464, vs. TLG). Patients with high tDV and high TLG, as determined by the receiver operating characteristic curve, had worse survival; moreover, patients with both high tDV and high TLG showed the worst prognosis (median progression-free and overall survival: 13.2 and 28.9 months, respectively).

Conclusions

Although tDV and TLG each reflected the total TV, in several cases, tDV and TLG were discrepant due to the biological features of each MM. It is important to use both modalities for complementary assessment of total tumor burden and biological characteristics in MM.

Key Points

• Total diffusion volume (tDV) and total lesion glycolysis (TLG) reflect the total tumor volume and have prognostic value in patients with multiple myeloma (MM).

• tDV and TLG could assess MM from different biological perspectives and should be considered for each patient individually.

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Abbreviations

ADC:

Apparent diffusion coefficient

BM:

Bone marrow

BMPC:

Bone marrow plasma cell

EMD:

Extramedullary disease

FL:

Focal lesions

IMPeTUs:

Italian Myeloma criteria for PET USe

ML:

Malignant lymphoma

SUVmax:

Maximum standard uptake value

MTV:

Metabolic tumor volume

MM:

Multiple myeloma

MY-RADS:

Myeloma Response Assessment and Diagnosis System

NDMM:

Newly diagnosed MM

PCs:

Plasma cells

ROI:

Regions-of-interest

tDV:

Total diffusion volume

TLG:

Total lesion glycolysis

TV:

Tumor volume

WB-MRI:

Whole-body magnetic response imaging

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Acknowledgements

The authors would like to thank the residents of the Department of Hematology/Oncology for their medical care to the patients, and the staff of the Division of Nuclear Medicine, Department of Radiology, for their assistance in this study. We also thank Editage (www.editage.jp) for their English language editing services.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Division of Haematology/Oncology, Department of Internal Medicine, Kameda Medical Centre, 929 Higashi-chou, Kamogawa, 296-8602, Japan

    Toshiki Terao, Kentaro Narita, Ayumi Kuzume, Rikako Tabata, Takafumi Tsushima, Daisuke Miura, Masami Takeuchi & Kosei Matsue

  2. Department of Radiology, Kameda Medical Centre, Kamogawa, Japan

    Youichi Machida

  3. Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan

    Ukihide Tateishi

Authors
  1. Toshiki Terao
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  2. Youichi Machida
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  3. Kentaro Narita
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  4. Ayumi Kuzume
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  5. Rikako Tabata
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  6. Takafumi Tsushima
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  7. Daisuke Miura
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  8. Masami Takeuchi
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  9. Ukihide Tateishi
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  10. Kosei Matsue
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Corresponding author

Correspondence to Toshiki Terao.

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Guarantor

The scientific guarantor of this publication is Kosei Matsue, the last author.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

This study includes data on patients from the previously reported study (DOI:10.1111/bjh.16633). The previous study included 185 patients reported from January 2009 to October 2019. Unlike the previous report, this present study includes additional assessments of WB-MRI and BMPCs. The reason for the observation period from 2016 to 2018 in this present study was because the protocol of MRI had not been determined before 2016.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Terao, T., Machida, Y., Narita, K. et al. Total diffusion volume in MRI vs. total lesion glycolysis in PET/CT for tumor volume evaluation of multiple myeloma. Eur Radiol 31, 6136–6144 (2021). https://doi.org/10.1007/s00330-021-07687-2

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  • DOI: https://doi.org/10.1007/s00330-021-07687-2

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