Giacomo Filonzi1,2,3, Katia Mancuso1, Elena Zamagni1, Cristina Nanni1, Paolo Spinnato2, Michele Cavo1, Stefano Fanti1, Eugenio Salizzoni1, Alberto Bazzocchi2. 1. 1 Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy. 2. 2 Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy. 3. 3 Ospedale di Porretta Terme, UOC Radiologia O. Bellaria e Area Sud-Est, Ausl Bologna, Bologna, Italy.
Abstract
OBJECTIVE: The objective of this study is to compare the most recent systems for the staging of multiple myeloma (MM), the Durie-Salmon PLUS system and the International Staging System, according to patients' survival rates and response to therapy. Another objective is to verify whether patterns of bone marrow alteration on MRI (i.e., focal, diffuse, or variegated patterns) can provide prognostic information for patients with MM. MATERIALS AND METHODS: We retrospectively enrolled 85 patients with MM who were monitored for a minimum of 6 years and who underwent contrast-enhanced spinal and pelvic MRI at 1.5 T and whole-body FDG PET/CT at the time of diagnosis. Patients underwent MM staging performed using both staging systems and were divided into groups on the basis of their MRI patterns. These patient groups were then compared in terms of survival, response to therapy, and duration of response. RESULTS: Both staging systems showed great capability in differentiating patients with a worse prognosis from patients with a better outcome, with the capability of both systems found to be statistically significant, albeit less statistically significant for the Durie-Salmon PLUS system (p = 0.010 vs p = 0.046, respectively). Patients with a focal pattern on MRI had a worse survival rate than did the patients with other MRI patterns (p = 0.032). CONCLUSION: These data indicate that both the International Staging System and the Durie-Salmon PLUS system have great potential for characterizing and stratifying MM to determine the survival outcome and therapy response of patients. Observation of a focal pattern on MRI seems to be associated with poorer survival.
OBJECTIVE: The objective of this study is to compare the most recent systems for the staging of multiple myeloma (MM), the Durie-Salmon PLUS system and the International Staging System, according to patients' survival rates and response to therapy. Another objective is to verify whether patterns of bone marrow alteration on MRI (i.e., focal, diffuse, or variegated patterns) can provide prognostic information for patients with MM. MATERIALS AND METHODS: We retrospectively enrolled 85 patients with MM who were monitored for a minimum of 6 years and who underwent contrast-enhanced spinal and pelvic MRI at 1.5 T and whole-body FDG PET/CT at the time of diagnosis. Patients underwent MM staging performed using both staging systems and were divided into groups on the basis of their MRI patterns. These patient groups were then compared in terms of survival, response to therapy, and duration of response. RESULTS: Both staging systems showed great capability in differentiating patients with a worse prognosis from patients with a better outcome, with the capability of both systems found to be statistically significant, albeit less statistically significant for the Durie-Salmon PLUS system (p = 0.010 vs p = 0.046, respectively). Patients with a focal pattern on MRI had a worse survival rate than did the patients with other MRI patterns (p = 0.032). CONCLUSION: These data indicate that both the International Staging System and the Durie-Salmon PLUS system have great potential for characterizing and stratifying MM to determine the survival outcome and therapy response of patients. Observation of a focal pattern on MRI seems to be associated with poorer survival.
Entities:
Keywords:
Durie-Salmon PLUS; MRI; bone marrow patterns; multiple myeloma; staging
Authors: Saravanabavaan Suntharalingam; Christian Mikat; Axel Wetter; Nika Guberina; Ahmed Salem; Philipp Heil; Michael Forsting; Kai Nassenstein Journal: Eur Radiol Date: 2018-01-10 Impact factor: 5.315