Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 9/2012

01-09-2012 | Magnetic Resonance

Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation

Authors: Peter Bannas, Hannah B. Hentschel, Thorsten A. Bley, András Treszl, Christine Eulenburg, Thorsten Derlin, Jin Yamamura, Gerhard Adam, Thomas Stübig, Nicolaus Kröger, Christoph Weber

Published in: European Radiology | Issue 9/2012

Login to get access

Abstract

Objectives

To compare the diagnostic performance of whole-body MRI (WBMRI) with haematological parameters for detecting persistent or relapsing disease in patients with multiple myeloma after stem cell transplantation.

Methods

Sixty-six WBMRI acquisitions were performed in 33 patients with multiple myeloma at two time points after stem cell transplantation. Extent of disease and inter-test dynamics of intra- and extramedullary myeloma manifestations were compared (kappa statistics) with Uniform Response Criteria, comprising haematological parameters.

Results

Using data from 66 sequential WBMRI acquisitions in 33 patients, 10 patients (30.3 %) were classified as having progressive disease and 23 (69.7 %) as being in remission. Eight (80 %) of the ten patients with progressive disease revealed intramedullary lesions, and two patients (20 %) had intra- and extramedullary lesions. WBMRI and laboratory tests were concordant in 26/33 (78.8 %) patients. We found an agreement of 51.2 %, 95 % confidence interval 19.8 %-82.6 %, between results from WBMRI and haematological parameters. WBMRI had a sensitivity of 63.6 %, specificity of 86.4 %, PPV of 70.0 %, NPV of 82.6 % and accuracy of 78.8 % for detection of remission.

Conclusions

WBMRI allows the detection and exact localisation of intra- and extramedullary myeloma manifestations after stem cell transplantation, but shows only moderate agreement with routinely performed laboratory tests for determination of remission.

Key Points

• Whole body magnetic resonance imaging (WBMRI) is increasingly used for oncological purposes
• WBMRI allows localisation of intra- and extramedullary myeloma manifestations after SCT
• However, WBMRI and serum analyses do not fully concur when assessing response
• Thus, WBMRI offers limited incremental value over laboratory tests to determine remission
Literature
1.
2.
3.
4.
Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108PubMedCrossRef
5.
Bensinger WI (2009) Role of autologous and allogeneic stem cell transplantation in myeloma. Leukemia 23:442–448PubMedCrossRef
6.
Lokhorst H, Einsele H, Vesole D et al. International Myeloma Working Group consensus statement regarding the current status of allogeneic stem-cell transplantation for multiple myeloma. J Clin Oncol 28:4521–4530
7.
Kroger N (2007) Mini-Midi-Maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation. Leukemia 21:1851–1858PubMedCrossRef
8.
Attal M, Harousseau JL, Facon T et al (2003) Single versus double autologous stem-cell transplantation for multiple myeloma. N Engl J Med 349:2495–2502PubMedCrossRef
9.
Barlogie B, Tricot GJ, van Rhee F et al (2006) Long-term outcome results of the first tandem autotransplant trial for multiple myeloma. Br J Haematol 135:158–164PubMedCrossRef
10.
Harousseau JL, Dreyling M (2009) Multiple myeloma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 20:97–99PubMedCrossRef
11.
Kroger N, Bacher U, Bader P et al. NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: report from the Committee on Disease-Specific Methods and Strategies for Monitoring Relapse following Allogeneic Stem Cell Transplantation. Part I: Methods, acute leukemias, and myelodysplastic syndromes. Biol Blood Marrow Transplant 16:1187–1211
12.
Rajkumar SV, Harousseau JL, Durie B et al. Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1. Blood 117:4691–4695
13.
Durie BG, Harousseau JL, Miguel JS et al (2006) International uniform response criteria for multiple myeloma. Leukemia 20:1467–1473PubMedCrossRef
14.
Dimopoulos M, Terpos E, Comenzo RL et al (2009) International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia 23:1545–1556PubMedCrossRef
15.
D'Sa S, Abildgaard N, Tighe J, Shaw P, Hall-Craggs M (2007) Guidelines for the use of imaging in the management of myeloma. Br J Haematol 137:49–63PubMed
16.
Derlin T, Weber C, Habermann CR et al (18)F-FDG PET/CT for detection and localization of residual or recurrent disease in patients with multiple myeloma after stem cell transplantation. Eur J Nucl Med Mol Imaging. doi: 10.​1007/​s00259-011-1993-8
17.
Fonti R, Salvatore B, Quarantelli M et al (2008) 18 F-FDG PET/CT, 99mTc-MIBI, and MRI in evaluation of patients with multiple myeloma. J Nucl Med 49:195–200PubMedCrossRef
18.
Shortt CP, Carty F, Murray JG. The role of whole-body imaging in the diagnosis, staging, and follow-up of multiple myeloma. Semin Musculoskelet Radiol 14:37–46
19.
Durie BG (2006) The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer 42:1539–1543PubMedCrossRef
20.
Lecouvet FE, Dechambre S, Malghem J, Ferrant A, Vande Berg BC, Maldague B (2001) Bone marrow transplantation in patients with multiple myeloma: prognostic significance of MR imaging. AJR Am J Roentgenol 176:91–96PubMed
21.
Lin C, Luciani A, Belhadj K et al. Multiple myeloma treatment response assessment with whole-body dynamic contrast-enhanced MR imaging. Radiology 254:521–531
22.
Blade J, Samson D, Reece D et al (1998) Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol 102:1115–1123PubMedCrossRef
23.
Kramer MS, Feinstein AR (1981) Clinical biostatistics. LIV. The biostatistics of concordance. Clin Pharmacol Ther 29:111–123PubMedCrossRef
24.
Bauerle T, Hillengass J, Fechtner K et al (2009) Multiple myeloma and monoclonal gammopathy of undetermined significance: importance of whole-body versus spinal MR imaging. Radiology 252:477–485PubMedCrossRef
25.
Horger M, Weisel K, Horger W, Mroue A, Fenchel M, Lichy M. Whole-body diffusion-weighted MRI with apparent diffusion coefficient mapping for early response monitoring in multiple myeloma: preliminary results. AJR Am J Roentgenol 196:W790-795
Metadata
Title
Diagnostic performance of whole-body MRI for the detection of persistent or relapsing disease in multiple myeloma after stem cell transplantation
Authors
Peter Bannas
Hannah B. Hentschel
Thorsten A. Bley
András Treszl
Christine Eulenburg
Thorsten Derlin
Jin Yamamura
Gerhard Adam
Thomas Stübig
Nicolaus Kröger
Christoph Weber
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 9/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2445-y

Other articles of this Issue 9/2012

European Radiology 9/2012 Go to the issue

Urogenital

Unenhanced CT findings can predict the development of urinary calculi in stone-free patients

Cardiac

Diagnostic performance of stress myocardial perfusion imaging for coronary artery disease: a systematic review and meta-analysis

Vascular-Interventional

Management of peripheral arterial interventions with mono or dual antiplatelet therapy—the MIRROR study: a randomised and double-blinded clinical trial

Cardiac

Evaluation of different magnetic resonance imaging techniques for the assessment of active left atrial emptying

Experimental

High accuracy of mesoscopic epi-fluorescence tomography for non-invasive quantitative volume determination of fluorescent protein-expressing tumours in mice

Interventional

MR-guided radiofrequency ablation using a wide-bore 1.5-T MR system: clinical results of 213 treated liver lesions