Document Detail


Multiple myeloma treatment response assessment with whole-body dynamic contrast-enhanced MR imaging.
MedLine Citation:
PMID:  20093523     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare posttreatment bone marrow changes at whole-body dynamic contrast material-enhanced magnetic resonance (MR) imaging with clinical response in patients with multiple myeloma (MM) and to determine if this technique can be used to assess treatment response in patients with MM. MATERIALS AND METHODS: This study was approved by an institutional review board; all patients gave informed written consent. Thirty patients (21 men, nine women; mean age, 58 years +/- 10 [standard deviation]) underwent whole-body dynamic contrast-enhanced MR imaging before treatment, after induction chemotherapy (n = 30), and after autologous stem cell transplantation (ASCT) (n = 20). Maximal percentages of bone marrow (BME(max)) and focal lesion (FLE(max)) enhancement were assessed at each MR imaging examination. Clinical responses were determined on the basis of international uniform response criteria. Posttreatment changes in BME(max)and FLE(max)were compared with clinical response to therapy by using the Mann-Whitney U test. Receiver operating characteristic (ROC) analysis of posttreatment BME(max)was used to identify poor responders. RESULTS: Eleven of 30 patients were good responders to induction chemotherapy; 16 of 20 patients were good responders to ASCT. After induction chemotherapy, mean BME(max)differed between good and poor responders (94.3% vs 138.4%, respectively; P = .02). With the exclusion of results from six examinations with focal lesions in which a poor clinical response was classified but BME(max)had normalized, a posttreatment BME(max)of more than 96.8% had 100% sensitivity for the identification of poor responders (specificity, 76.9%; area under the ROC curve, 0.90; P = .0001). Mean FLE(max)after induction chemotherapy did not differ between good and poor responders. Mean timing (ie, the number of postcontrast dynamic acquisitions where FLE(max)was observed) was significantly delayed in good responders compared with poor responders (4.7 vs 2.9, P < .0001). Post-ASCT MR imaging results correctly depicted all four clinically good responders whose disease subsequently progressed. CONCLUSION: With quantitative analysis of BME(max)and the timing of FLE(max), whole-body dynamic contrast-enhanced MR imaging can be used to assess treatment response in patients with MM.
Authors:
Chieh Lin; Alain Luciani; Karim Belhadj; Jean-Fran?ois Deux; Fr?d?rique Kuhnowski; Mezri Maatouk; Pauline Beaussart; Charles A Cuenod; Corinne Haioun; Alain Rahmouni
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Radiology     Volume:  254     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-22     Completed Date:  2010-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  521-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Medical Imaging, AP-HP, Groupe Henri-Mondor Albert-Chenevier, 51 Avenue du Malr?chal de Lattre de Tassigny, 94010 Cr?teil, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bone Marrow / pathology*
Contrast Media
Disease Progression
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Meglumine / diagnostic use
Middle Aged
Multiple Myeloma / pathology*,  therapy*
Organometallic Compounds / diagnostic use
ROC Curve
Retrospective Studies
Statistics, Nonparametric
Stem Cell Transplantation
Transplantation, Autologous
Treatment Outcome
Whole Body Imaging*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 0/gadoterate meglumine; 6284-40-8/Meglumine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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