Can Diffusion and Chemical Shift Imaging quantitative MRI metrics predict response to therapy in patients affected by Multiple Myeloma with focal lesions?

Congress:

ESSR 2019

Poster Number:

P-0017

Type:

Scientific Poster

Keywords:

Imaging sequences, MR, Musculoskeletal spine, Musculoskeletal bone

Authors:

S. Berardo, A. Trisoglio, E. Soligo, L. SUKHOVEI , G. F. buoni, A. Carriero, A. Stecco; Novara/IT

DOI:

10.26044/essr2019/P-0017

DOI-Link:

https://dx.doi.org/10.26044/essr2019/P-0017

Fig. 2: ADC map before and after therapy. The ROI was drawed on the focal lesion of the...

Fig. 3: DIXON IP and OP figures before and after therapy. The ROI was drawed on the...

Purpose

Retrospectively evaluate if MRI “functional” quantitative parameters, as “ADC” and “fat fraction”, calculated on focal Multiple Myeloma lesions, correlate with clinical response to therapy.

Methods and Materials

We retrospectively evaluated 14 patients (6M/8W; mean age 66y, range 54-75y) with symptomatic MM and focal bone marrow lesions who underwent Whole Body MRI before and after therapy (average MRIs’ distance: 9,9 month). MRI were performed on a 1.5T scanner. Sequences: STIR, DWIBS (3 b values: 50-400-800 sec/mm2); Coronal T1SE with Chemical Shift technique, registering in phase (water+fat), and out phase (water-fat). We evaluated 43 lesions before and after therapy, by placing a ROI on lesions in ADC map and in the in and out...

Results

Patient’s clinical response: 9 complete response, 3 partial response, 2 very good partial response. Mean ADC pre-therapy: 0.82*10-3 mm2/s (0.566 - 1.259); after therapy: 1.460*10-3 mm2/s (0.594 - 2.800). Mean FF pre-therapy: 0.10 (0.001 - 0.34); after therapy: 0.18 (0.005 - 0.36).We find a statistical difference in lesion’s area reduction (p=0,009); by evaluating the different category of patients, there is no statistical difference in lesion’s area reduction in patients with PR (p=0.9). There is a statistical difference in lesion’s FF before and after therapy (p<0.0001)...

Conclusion

In patients with MM, ADC can correlate with clinic response to therapy with an increase of the mean value, while there is no correlation between FF and clinical response therapy.

References

Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548.Doi:10.1016/S1470-2045(14)70442-5. Latifoltojar A, Hall-Craggs M, Rabin N, et al. Whole body magnetic resonance imaging in newly diagnosed multiple myeloma: early changes in lesional signal fat fraction predict disease response. British Journal of Haematology. 2017; 176(2):222-233. Doi:10.1111/bjh.14401. Kumar S, Paiva B, Anderson KC, et Al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;...