Semin Musculoskelet Radiol 2023; 27(S 01): S1-S24
DOI: 10.1055/s-0043-1770044
Oral Presentation

Evaluating Treatment Response in Multiple Myeloma Patients with Quantitative Analysis of Whole-Body Diffusion-weighted Imaging-Magnetic Resonance Imaging

Dr. Alberto Paternain
Dr. Francisco Javier Mendoza
Dr. César Urtasun
Mariana Elorz
Miguel Barrio
Jesús Dámaso Aquerreta

Purpose or Learning Objective: To evaluate the feasibility of quantitative whole-body diffusion-weighted imaging-magnetic resonance imaging (DWI-MRI) analysis using a semiautomatic segmentation technique for treatment response assessment in multiple myeloma patients.

Methods or Background: A total of 34 patients with multiple myeloma had a whole-body MRI performed in our institution. Images were acquired and reported according to Myeloma Response Assessment and Diagnosis System guidelines. Patients were classified as responders or nonresponders according to both their Response Assessment Category by MRI and the response category given following the International Myeloma Working Group (IMWG) criteria, considering the last zone as the gold standard. A quantitative analysis of the DWI images of each MRI was performed after semiautomatic segmentation. Data analysis was performed using SPSS v.25.0 software (unpaired and paired t tests). Two-tailed P values were used for all statistical assessments, and a P value < 0.05 was considered statistically significant.

Results or Findings: Thirteen patients (38.2%) did not respond to treatment according to the IMWG response criteria. They did not show statistically significant differences in the total diffusion volume (tDV: 240.82 cm3 versus 196.08 cm3; P = 0.507) or mean global apparent diffusion coefficient (gADC: 694.92 × 10−6 mm2/s versus 779.4 × 10−6 mm2/s; P = 0.123) in the quantitative DWI analysis before and after treatment, respectively.

Among the remaining 21 responding patients (61.8%), tDV significantly decreased (214.93 cm3 versus 111.41 cm3; P = 0.01) and gADC significantly increased (738.82 × 10−6 mm2/s versus 1,126.29 × 10−6 mm2/s; P = 0.002) after treatment. In addition, the percentage of high ADC values (≥ 1,400 × 10−6 mm2/s) from the tDV was higher in responding patients after treatment (36.57%) than in nonresponders (7.8%), with significant differences (P < 0.001).

Conclusion: The tDV and gADC may be feasible parameters for assessing treatment response in multiple myeloma patients.

Publication History

Article published online:
26 May 2023

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