C Lacognata1, F Crimì2, A Guolo3, C Varin4, E De March5, S Vio1, A Ponzoni1, G Barilà5, A Lico5, A Branca5, E De Biasi6, F Gherlinzoni7, V Scapin1, E Bissoli8, T Berno5, R Zambello5. 1. Radiology Section, Department of Medicine DIMED, University-Hospital of Padua, Italy. 2. Radiology Section, Department of Medicine DIMED, University-Hospital of Padua, Italy. Electronic address: crimifilippo@gmail.com. 3. Department of Statistical Sciences, Padua University, Italy. 4. Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University, Venice, Italy. 5. Hematology and Clinical Immunology Section, Department of Medicine DIMED, University-Hospital of Padua, Italy. 6. Department of Hematology, Camposampiero Hospital, Padua, Italy. 7. Department of Hematology, Ca' Foncello Hospital, Treviso, Italy. 8. Department of Radiology, Camposampiero Hospital, Padua, Italy.
Abstract
AIM: To evaluate the modifications of the apparent diffusion coefficient (ADC) in myelomatous lesions before and after induction treatment and the correlation with patient response to therapy according to International Myeloma Working Group (IMWG) criteria. MATERIALS AND METHODS: A homogeneous group of 18 patients with a diagnosis of symptomatic multiple myeloma who underwent whole-body MRI with diffusion-weighted imaging (DWI-MRI) before and after bortezomib-based induction chemotherapy were evaluated prospectively. Quantitative analysis of ADC maps of myelomatous lesions was performed with the following pattern types: focal pattern, diffuse pattern (moderate and severe), and "salt and pepper" pattern. Lesions were evaluated by quantitative image analysis including measurement of the mean ADC in three measurements. Imaging results were compared to laboratory results as the clinical reference standard. RESULTS: A statistically significant increase in ADC values were found in the lesions of patients that responded to treatment. Interestingly, focal lesions showed a strongly significant increase in ADC values in responders, whereas no significant variation in ADC value in non-focal lesions (diffuse pattern and "salt and peppers" pattern) between responders and non-responders group was demonstrated. CONCLUSIONS: DWI-MRI could provide additional quantitative information useful in monitoring early therapy response according to ADC changes of focal lesions.
AIM: To evaluate the modifications of the apparent diffusion coefficient (ADC) in myelomatous lesions before and after induction treatment and the correlation with patient response to therapy according to International Myeloma Working Group (IMWG) criteria. MATERIALS AND METHODS: A homogeneous group of 18 patients with a diagnosis of symptomatic multiple myeloma who underwent whole-body MRI with diffusion-weighted imaging (DWI-MRI) before and after bortezomib-based induction chemotherapy were evaluated prospectively. Quantitative analysis of ADC maps of myelomatous lesions was performed with the following pattern types: focal pattern, diffuse pattern (moderate and severe), and "salt and pepper" pattern. Lesions were evaluated by quantitative image analysis including measurement of the mean ADC in three measurements. Imaging results were compared to laboratory results as the clinical reference standard. RESULTS: A statistically significant increase in ADC values were found in the lesions of patients that responded to treatment. Interestingly, focal lesions showed a strongly significant increase in ADC values in responders, whereas no significant variation in ADC value in non-focal lesions (diffuse pattern and "salt and peppers" pattern) between responders and non-responders group was demonstrated. CONCLUSIONS: DWI-MRI could provide additional quantitative information useful in monitoring early therapy response according to ADC changes of focal lesions.
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