Share:
Share this content in WeChat
X
Review
Application progress of MRI in the prognostic prediction of multiple myeloma
LI Jiao  WANG Qin  XUE Huadan  JIN Zhengyu 

LI J, WANG Q, XUE H D, et al. Application progress of MRI in the prognostic prediction of multiple myeloma[J]. Chin J Magn Reson Imaging, 2023, 14(8): 192-196. DOI:10.12015/issn.1674-8034.2023.08.034.


[Abstract] Multiple myeloma (MM) is a common hematologic malignancy with varying outcomes and survival rates ranging from a few months to more than ten years. Accurate prognosis assessment and risk stratification are essential for the individualized treatment of MM. In recent years, MRI, as the most sensitive imaging technique for detecting bone marrow infiltration in MM, has been widely used in the research of MM prognosis prediction. In this paper, the research value of different MRI techniques in predicting the prognosis of MM is emphasized, and some references are provided for future research and clinical work.
[Keywords] multiple myeloma;prognosis;magnetic resonance imaging;whole body diffusion weighted imaging;application progress

LI Jiao   WANG Qin   XUE Huadan   JIN Zhengyu*  

Department of Radiology, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Corresponding author: Jin ZY, E-mail: jinzy@pumch.cn.

Conflicts of interest   None.

ACKNOWLEDGMENTS Fundamental Research Funds for the Central University (No. 3332021014); CAMS Innovation Fund for Medical Sciences (No. 2020-I2M-C&T-B-037); Beijing Natural Science Foundation (No. L222099); Beijing Science and Technology Planning Project (No. Z211100002921067).
Received  2023-03-12
Accepted  2023-06-26
DOI: 10.12015/issn.1674-8034.2023.08.034
LI J, WANG Q, XUE H D, et al. Application progress of MRI in the prognostic prediction of multiple myeloma[J]. Chin J Magn Reson Imaging, 2023, 14(8): 192-196. DOI:10.12015/issn.1674-8034.2023.08.034.

[1]
VAN DE DONK N W C J, PAWLYN C, YONG K L. Multiple myeloma[J]. Lancet, 2021, 397(10272): 410-427. DOI: 10.1016/s0140-6736(21)00135-5.
[2]
MARCON C, SIMEON V, DEIAS P, et al. Experts' consensus on the definition and management of high risk multiple myeloma[J/OL]. Front Oncol, 2022, 12: 1096852 [2023-05-17]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899889. DOI: 10.3389/fonc.2022.1096852.
[3]
MA K W, SUN C, LI J Y, et al. Research progress on prognostic factors of multiple myeloma—review[J]. J Exp Hematol, 2021, 29(4): 1346-1350. DOI: 10.19746/j.cnki.issn1009-2137.2021.04.053.
[4]
DURIE B G M, SALMON S E. A clinical staging system for multiple myeloma correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival[J]. Cancer, 1975, 36(3): 842-854. DOI: 10.1002/1097-0142(197509)36:3<842:aid-cncr2820360303>3.0.co;2-u.
[5]
PALUMBO A, AVET-LOISEAU H, OLIVA S, et al. Revised international staging system for multiple myeloma: a report from international myeloma working group[J]. J Clin Oncol, 2015, 33(26): 2863-2869. DOI: 10.1200/JCO.2015.61.2267.
[6]
RAJKUMAR S V. Multiple myeloma: 2022 update on diagnosis, risk stratification, and management[J]. Am J Hematol, 2022, 97(8): 1086-1107. DOI: 10.1002/ajh.26590.
[7]
COWAN A J, GREEN D J, KWOK M, et al. Diagnosis and management of multiple myeloma: a review[J]. JAMA, 2022, 327(5): 464-477. DOI: 10.1001/jama.2022.0003.
[8]
HILLENGASS J, USMANI S, RAJKUMAR S V, et al. International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders[J/OL]. Lancet Oncol, 2019, 20(6): e302-e312 [2022-11-18]. https://www.sciencedirect.com/science/article/pii/S1470204519303092?via%3Dihub. DOI: 10.1016/S1470-2045(19)30309-2.
[9]
HEIDEMEIER A, SCHLOETELBURG W, THURNER A, et al. Multi-parametric whole-body MRI evaluation discerns vital from non-vital multiple myeloma lesions as validated by 18F-FDG and 11C-methionine PET/CT[J/OL]. Eur J Radiol, 2022, 155: 110493 [2023-05-21]. https://www.sciencedirect.com/science/article/pii/S0720048X22003436?via%3Dihub. DOI: 10.1016/j.ejrad.2022.110493.
[10]
LIBSHITZ H I, MALTHOUSE S R, CUNNINGHAM D, et al. Multiple myeloma: appearance at MR imaging[J]. Radiology, 1992, 182(3): 833-837. DOI: 10.1148/radiology.182.3.1535904.
[11]
WEININGER M, LAUTERBACH B, KNOP S, et al. Whole-body MRI of multiple myeloma: comparison of different MRI sequences in assessment of different growth patterns[J]. Eur J Radiol, 2009, 69(2): 339-345. DOI: 10.1016/j.ejrad.2007.10.025.
[12]
SUN M T, CHENG J L, REN C P, et al. Differentiation of diffuse infiltration pattern in multiple myeloma from hyperplastic hematopoietic bone marrow: qualitative and quantitative analysis using whole-body MRI[J]. J Magn Reson Imaging, 2022, 55(4): 1213-1225. DOI: 10.1002/jmri.27934.
[13]
JI X D, HUANG W Y, DONG H Z, et al. Evaluation of bone marrow infiltration in multiple myeloma using whole-body diffusion-weighted imaging and T1-weighted water-fat separation Dixon[J]. Quant Imaging Med Surg, 2021, 11(2): 641-651. DOI: 10.21037/qims-20-289.
[14]
BERARDO S, SUKHOVEI L, ANDORNO S, et al. Quantitative bone marrow magnetic resonance imaging through apparent diffusion coefficient and fat fraction in multiple myeloma patients[J]. Radiol Med, 2021, 126(3): 445-452. DOI: 10.1007/s11547-020-01258-z.
[15]
TORKIAN P, AZADBAKHT J, ANDREA BONAFFINI P, et al. Advanced imaging in multiple myeloma: new frontiers for MRI[J/OL]. Diagnostics (Basel), 2022, 12(9): 2182 [2023-03-14] . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497462. DOI: 10.3390/diagnostics12092182.
[16]
MOULOPOULOS L A, VARMA D G, DIMOPOULOS M A, et al. Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease[J]. Radiology, 1992, 185(3): 833-840. DOI: 10.1148/radiology.185.3.1438772.
[17]
VANDE BERG B C, KIRCHGESNER T, ACID S, et al. Diffuse vertebral marrow changes at MRI: multiple myeloma or normal?[J]. Skeletal Radiol, 2022, 51(1): 89-99. DOI: 10.1007/s00256-021-03886-6.
[18]
VAN DEN BERGHE T, VERSTRAETE K L, LECOUVET F E, et al. Review of diffusion-weighted imaging and dynamic contrast-enhanced MRI for multiple myeloma and its precursors (monoclonal gammopathy of undetermined significance and smouldering myeloma)[J]. Skeletal Radiol, 2022, 51(1): 101-122. DOI: 10.1007/s00256-021-03903-8.
[19]
STÄBLER A, BAUR A, BARTL R, et al. Contrast enhancement and quantitative signal analysis in MR imaging of multiple myeloma: assessment of focal and diffuse growth patterns in marrow correlated with biopsies and survival rates[J]. AJR Am J Roentgenol, 1996, 167(4): 1029-1036. DOI: 10.2214/ajr.167.4.8819407.
[20]
SONG M K, CHUNG J S, LEE J J, et al. Magnetic resonance imaging pattern of bone marrow involvement as a new predictive parameter of disease progression in newly diagnosed patients with multiple myeloma eligible for autologous stem cell transplantation[J]. Br J Haematol, 2014, 165(6): 777-785. DOI: 10.1111/bjh.12820.
[21]
MOULOPOULOS L A, DIMOPOULOS M A, KASTRITIS E, et al. Diffuse pattern of bone marrow involvement on magnetic resonance imaging is associated with high risk cytogenetics and poor outcome in newly diagnosed, symptomatic patients with multiple myeloma: a single center experience on 228 patients[J]. Am J Hematol, 2012, 87(9): 861-864. DOI: 10.1002/ajh.23258.
[22]
SONG M K, CHUNG J S, LEE J J, et al. Risk stratification model in elderly patients with multiple myeloma: clinical role of magnetic resonance imaging combined with international staging system and cytogenetic abnormalities[J]. Acta Haematol, 2015, 134(1): 7-16. DOI: 10.1159/000370235.
[23]
MAI E K, HIELSCHER T, KLOTH J K, et al. Association between magnetic resonance imaging patterns and baseline disease features in multiple myeloma: analyzing surrogates of tumour mass and biology[J]. Eur Radiol, 2016, 26(11): 3939-3948. DOI: 10.1007/s00330-015-4195-0.
[24]
HILLENGASS J, FECHTNER K, WEBER M A, et al. Prognostic significance of focal lesions in whole-body magnetic resonance imaging in patients with asymptomatic multiple myeloma[J]. J Clin Oncol, 2010, 28(9): 1606-1610. DOI: 10.1200/JCO.2009.25.5356.
[25]
KASTRITIS E, MOULOPOULOS L A, TERPOS E, et al. The prognostic importance of the presence of more than one focal lesion in spine MRI of patients with asymptomatic (smoldering) multiple myeloma[J]. Leukemia, 2014, 28(12): 2402-2403. DOI: 10.1038/leu.2014.230.
[26]
WALKER R, BARLOGIE B, HAESSLER J, et al. Magnetic resonance imaging in multiple myeloma: diagnostic and clinical implications[J]. J Clin Oncol, 2007, 25(9): 1121-1128. DOI: 10.1200/jco.2006.08.5803.
[27]
AILAWADHI S, ABDELHALIM A N, DERBY L, et al. Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myeloma[J]. Cancer, 2010, 116(1): 84-92. DOI: 10.1002/cncr.24704.
[28]
LIU J F, ZENG P E, GUO W, et al. Prediction of high-risk cytogenetic status in multiple myeloma based on magnetic resonance imaging: utility of radiomics and comparison of machine learning methods[J]. J Magn Reson Imaging, 2021, 54(4): 1303-1311. DOI: 10.1002/jmri.27637.
[29]
LIU J F, WANG C J, GUO W, et al. A preliminary study using spinal MRI-based radiomics to predict high-risk cytogenetic abnormalities in multiple myeloma[J]. Radiol Med, 2021, 126(9): 1226-1235. DOI: 10.1007/s11547-021-01388-y.
[30]
LI Y, LIU Y, YIN P, et al. MRI-based bone marrow radiomics nomogram for prediction of overall survival in patients with multiple myeloma[J/OL]. Front Oncol, 2021, 11: 709813 [2023-03-16]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671997. DOI: 10.3389/fonc.2021.709813.
[31]
MOULOPOULOS L A, GIKA D, ANAGNOSTOPOULOS A, et al. Prognostic significance of magnetic resonance imaging of bone marrow in previously untreated patients with multiple myeloma[J]. Ann Oncol, 2005, 16(11): 1824-1828. DOI: 10.1093/annonc/mdi362.
[32]
SCHERER A, WITTSACK H J, STRUPP C, et al. Vertebral fractures in multiple myeloma: first results of assessment of fracture risk using dynamic contrast-enhanced magnetic resonance imaging[J]. Ann Hematol, 2002, 81(9): 517-521. DOI: 10.1007/s00277-002-0532-x.
[33]
HILLENGASS J, RITSCH J, MERZ M, et al. Increased microcirculation detected by dynamic contrast-enhanced magnetic resonance imaging is of prognostic significance in asymptomatic myeloma[J]. Br J Haematol, 2016, 174(1): 127-135. DOI: 10.1111/bjh.14038.
[34]
HILLENGASS J, WASSER K, DELORME S, et al. Lumbar bone marrow microcirculation measurements from dynamic contrast-enhanced magnetic resonance imaging is a predictor of event-free survival in progressive multiple myeloma[J]. Clin Cancer Res, 2007, 13(2Pt 1): 475-481. DOI: 10.1158/1078-0432.CCR-06-0061.
[35]
HUANG S Y, CHEN B B, LU H Y, et al. Correlation among DCE-MRI measurements of bone marrow angiogenesis, microvessel density, and extramedullary disease in patients with multiple myeloma[J]. Am J Hematol, 2012, 87(8): 837-839. DOI: 10.1002/ajh.23256.
[36]
MERZ M, MOEHLER T M, RITSCH J, et al. Prognostic significance of increased bone marrow microcirculation in newly diagnosed multiple myeloma: results of a prospective DCE-MRI study[J]. Eur Radiol, 2016, 26(5): 1404-1411. DOI: 10.1007/s00330-015-3928-4.
[37]
ANDRULIS M, BÄUERLE T, GOLDSCHMIDT H, et al. Infiltration patterns in monoclonal plasma cell disorders: correlation of magnetic resonance imaging with matched bone marrow histology[J]. Eur J Radiol, 2014, 83(6): 970-974. DOI: 10.1016/j.ejrad.2014.03.005.
[38]
WU F B, BERNARD S, FAYAD L M, et al. Updates and ongoing challenges in imaging of multiple myeloma: AJR expert panel narrative review[J]. Am J Roentgenol, 2021, 217(4): 775-785. DOI: 10.2214/ajr.21.25878.
[39]
BRIOLI A, MORGAN G J, DURIE B, et al. The utility of newer imaging techniques as predictors of clinical outcomes in multiple myeloma[J]. Expert Rev Hematol, 2014, 7(1): 13-16. DOI: 10.1586/17474086.2014.873347.
[40]
HAMEED M, SANDHU A, SONEJI N, et al. Pictorial review of whole body MRI in myeloma: emphasis on diffusion-weighted imaging[J/OL]. Br J Radiol, 2020, 93(1115): 20200312 [2023-05-17]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519646. DOI: 10.1259/bjr.20200312.
[41]
GUIRGUIS M, SHARAN G, WANG J, et al. Diffusion-weighted MR imaging of musculoskeletal tissues: incremental role over conventional MR imaging in bone, soft tissue, and nerve lesions[J/OL]. BJR Open, 2022, 4(1): 20210077 [2023-05-17]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667480. DOI: 10.1259/bjro.20210077.
[42]
MESGUICH C, HULIN C, LATRABE V, et al. Prospective comparison of 18-FDG PET/CT and whole-body diffusion-weighted MRI in the assessment of multiple myeloma[J]. Ann Hematol, 2020, 99(12): 2869-2880. DOI: 10.1007/s00277-020-04265-2.
[43]
SUROV A, MEYER H J, WIENKE A. Correlation between minimum apparent diffusion coefficient (ADCmin) and tumor cellularity: a meta-analysis[J]. Anticancer Res, 2017, 37(7): 3807-3810. DOI: 10.21873/anticanres.11758.
[44]
MORANI A C, ELSAYES K M, LIU P S, et al. Abdominal applications of diffusion-weighted magnetic resonance imaging: where do we stand[J]. World J Radiol, 2013, 5(3): 68-80. DOI: 10.4329/wjr.v5.i3.68.
[45]
RASCHE L, KUMAR M, GERSHNER G, et al. Lack of Spleen Signal on Diffusion Weighted MRI is associated with High Tumor Burden and Poor Prognosis in Multiple Myeloma: a Link to Extramedullary Hematopoiesis?[J]. Theranostics, 2019, 9(16): 4756-4763. DOI: 10.7150/thno.33289.
[46]
ZHANG L, WANG Q, WU X, et al. Baseline bone marrow ADC value of diffusion-weighted MRI: a potential independent predictor for progression and death in patients with newly diagnosed multiple myeloma[J]. Eur Radiol, 2021, 31(4): 1843-1852. DOI: 10.1007/s00330-020-07295-6.
[47]
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[J]. Eur Radiol, 2021, 31(8): 6136-6144. DOI: 10.1007/s00330-021-07687-2.
[48]
WANG Q, ZHANG L, LI S, et al. Histogram analysis based on apparent diffusion coefficient maps of bone marrow in multiple myeloma: an independent predictor for high-risk patients classified by the revised international staging system[J/OL]. Acad Radiol, 2022, 29(6): e98-e107 [2022-12-21]. https://www.sciencedirect.com/science/article/pii/S1076633221003184?via%3Dihub. DOI: 10.1016/j.acra.2021.07.010.
[49]
PAWLYN C, FOWKES L, OTERO S, et al. Whole-body diffusion-weighted MRI: a new gold standard for assessing disease burden in patients with multiple myeloma?[J]. Leukemia, 2016, 30(6): 1446-1448. DOI: 10.1038/leu.2015.338.
[50]
ELGENDY K, BARWICK T D, AUNER H W, et al. Repeatability and test-retest reproducibility of mean apparent diffusion coefficient measurements of focal and diffuse disease in relapsed multiple myeloma at 3T whole body diffusion-weighted MRI (WB-DW-MRI)[J/OL]. Br J Radiol, 2022, 95(1138): 20220418 [2022-12-21]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815750. DOI: 10.1259/bjr.20220418.
[51]
JO A, JUNG J Y, LEE S Y, et al. Prognosis prediction in initially diagnosed multiple myeloma patients using intravoxel incoherent motion-diffusion weighted imaging and multiecho Dixon imaging[J]. J Magn Reson Imaging, 2021, 53(2): 491-501. DOI: 10.1002/jmri.27321.
[52]
SUN M T, CHENG J L, REN C P, et al. Quantitative whole-body MR imaging for assessment of tumor burden in patients with multiple myeloma: correlation with prognostic biomarkers[J]. Quant Imaging Med Surg, 2021, 11(8): 3767-3780. DOI: 10.21037/qims-20-1361.
[53]
GU Y W, WU Y, YAN R X, et al. Application of MRI water-fat separation technology in patients with multiple myeloma[J]. J Exp Hematol, 2022, 30(1): 183-188. DOI: 10.19746/j.cnki.issn1009-2137.2022.01.030.

PREV Research progress of MRI radiomics in the evaluation of adverse pathological factors of early cervical cancer
NEXT Application of superparamagnetic iron oxide nanoparticle in the diagnosis and treatment of tumor
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn